Supraglottoplasty

What is supraglottoplasty surgery?

Supraglottoplasty refers to a procedure in which your surgeon removes excess tissue from your upper larynx (voice box). This prevents the tissue from falling back over the airway and interfering with breathing.

What is laser supraglottoplasty?

Your surgeon may use traditional surgical instruments or laser therapy to perform supraglottoplasty. Your healthcare provider will talk with you about which option is best.

Who needs to have supraglottoplasty?

The procedure can be performed on people of all ages, but it is most commonly performed on children.

What does supraglottoplasty treat?

This procedure is most commonly used to treat laryngomalacia. This condition is congenital, meaning people are born with it. Babies with laryngomalacia have floppy or malformed tissue around their voice box that falls back over their airway. Supraglottoplasty surgery removes or reshapes the tissue to improve breathing. Supraglottoplasty may also be used to treat certain cases of obstructive sleep apnea (OSA) in both children and adults.

How common is supraglottoplasty?

Laryngomalacia is the most frequent cause of noisy breathing in babies. Most cases resolve on their own without surgical intervention. However, a small percentage of children with laryngomalacia require supraglottoplasty.

What happens before supraglottoplasty?

If your baby has been diagnosed with laryngomalacia, your healthcare provider will discuss your treatment options with you. Before deciding on supraglottoplasty, they may first recommend close monitoring — especially in mild cases. If your child’s condition is related to GERD (chronic acid reflux), then medications may be prescribed. If conservative treatments are unsuccessful, then your healthcare provider will likely recommend supraglottoplasty.

How is supraglottoplasty done?

Supraglottoplasty is performed in a hospital under general anesthesia. Your surgeon performs the procedure through the mouth, using small instruments. So, no incisions are made on the outside of the body. The floppy, excess tissue around the top of the larynx is carefully removed and reshaped. This allows more air to pass through to the trachea (windpipe).

How long is supraglottoplasty surgery?

Supraglottoplasty surgery can usually be completed in about one hour. Your child may or may not need a temporary breathing tube the night after the procedure.

What can I expect after supraglottoplasty?

There will be some degree of swelling following supraglottoplasty. For this reason, your child may sound worse or have feeding difficulties for the first week or two after surgery. This is normal and is not a cause for concern. In most cases, these issues resolve in about 10 to 14 days.

What are the advantages of supraglottoplasty?

One of the most notable advantages of supraglottoplasty is that it can encourage weight gain in children. Some children have such a difficult time breathing that they end up burning more calories than usual, resulting in unwanted weight loss. Supraglottoplasty can address this problem.

Are there supraglottoplasty complications or risks?

Like any surgical procedure, there are possible risks or complications associated with supraglottoplasty. Complications may include:

• Difficulty swallowing or aspiration.
• Infection.
• Bleeding.
• Blood clots.
• Damage to surrounding structures.
• Continued breathing difficulties.

Your healthcare provider will monitor your child closely after supraglottoplasty to ensure they are healing properly. You can reduce your child’s risk for complications by following the post-operative guidelines provided by your surgical team.

What is the recovery time?

On average, pain following supraglottoplasty lasts for about one week. However, this can vary depending on the severity of your child’s condition and the extent of surgery. Your surgeon will provide anti-reflux drugs, pain relievers or other medications to keep your child comfortable during the recovery period.

What is the supraglottoplasty success rate?

According to several research studies, supraglottoplasty is reported to have a success rate of 70% to 100%. Findings indicate that success rates are lower in children with certain syndromes, neurological issues or heart problems.

When should I see my healthcare provider?

Call your healthcare provider if your child develops:

• An increase in noisy breathing after two weeks.
• Shortness of breath (dyspnea).
• Fever.
• Pain that doesn’t go away with medication.
• Inability to drink liquids.
• Coughing when drinking liquids.

A note from Cleveland Clinic

In many cases, laryngomalacia and other congenital disorders of the larynx resolve themselves without surgical intervention. However, in some instances, supraglottoplasty is necessary to improve your child’s ability to breathe. It can be scary any time your healthcare provider recommends surgery for your child. However, supraglottoplasty can effectively improve your child’s overall quality of life. Ask your provider for resources so you can make an informed decision about your child’s health.