Improved growth curve measurements after supraglottoplasty.

Abstract

To evaluate changes in growth curve measurements after supraglottoplasty and compare these patterns to patients with laryngomalacia treated conservatively. Retrospective case-control study. Children treated surgically for laryngomalacia were compared to control groups of patients who underwent observation or medical treatment only. Body weight the day of surgery and on follow-up visits was plotted on a standardized growth curve and the z-score calculated. A total of 15 patients were included that were observed (group 1), 71 patients that were treated with medical therapy only (group 2), and 29 patients that underwent surgery (group 3). The average z-score at the time of surgery was significantly worse in group 3 (-0.854 ± 1.080), compared to the z-score at the time of diagnosis in group 1 (-0.086 ± 0.834), and the time when antireflux therapy was initiated in group 2 (-0.120 ± 0.979). Within 3 months from surgery, significant improvement on the growth curve was seen in group 3 (P = .009). After 12 months, all three groups approached the mean on the growth curve. In this series, patients with severe laryngomalacia who warranted surgery presented with significantly lower percentile weight on a standardized growth curve than patients who required only medical or conservative treatment. Substantial improvement in growth curve percentile was seen in the immediate months following supraglottoplasty. Long-term follow-up after supraglottoplasty shows that infants return to a mean weight on the growth curve.