Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 1;20(1):9-16.
doi: 10.5664/jcsm.10770.

Polysomnographic parameters and clinical risk factors predicting postoperative respiratory complications in children undergoing supraglottoplasty

Sawita Kanavitoon  1   2 , Pornswan Ngamprasertwong  2 , Neepa Gurbani  3   4 , Aisaku Nakamura  5 , Md Monir Hossain  3   4   5 , Christine H Heubi  3   6   7 , Narong Simakajornboon  3   4
Affiliations

Polysomnographic parameters and clinical risk factors predicting postoperative respiratory complications in children undergoing supraglottoplasty

Sawita Kanavitoon et al. J Clin Sleep Med. .

Abstract

Study objectives: Postoperative respiratory complications (PORCs) can occur following supraglottoplasty (SGP) for obstructive sleep apnea. However, there are very limited data on risk factors associated with these complications. This study aims to evaluate the occurrence of PORC in children undergoing SGP and to assess clinical factors and polysomnographic parameters predicting these complications.

Methods: A retrospective study was performed in children with laryngomalacia who underwent SGP with preoperative polysomnography.

Results: 400 children who underwent SGP met the criteria for entry into the analysis with a total of 416 surgeries with corresponding preoperative polysomnography. The median age (interquartile range) at the time of polysomnography was 0.4 (0.2, 1.5) years. A total of 96 (23.1%) PORCs were noted. Compared with those without complications, children with PORCs had a higher proportion of congenital heart disease (P < .05), higher median obstructive apnea-hypopnea index (obstructive AHI; median 16.0 vs 11.4 events/h; P < .01), and lower median oxygen saturation (SpO2) (P < .001). The unadjusted odd ratio indicated an increased risk of PORCs in children with congenital heart disease (odds ratio 1.66; P < .05) and those with an obstructive AHI > 10 events/h (odds ratio 2.06; P < .01). Multiple regression analysis demonstrated that an obstructive AHI > 10 events/h was the only independent risk factor for PORCs (P < .05).

Conclusions: In our cohort of children with laryngomalacia undergoing SGP, those with underlying congenital heart disease, higher obstructive AHI, and lower SpO2 were more likely to develop PORCs. Only children with an obstructive AHI > 10 events/h were at significantly increased risk for PORCs following SGP. Preoperative polysomnography is useful in preoperative planning in children undergoing SGP.

Citation: Kanavitoon S, Ngamprasertwong P, Gurbani N, et al. Polysomnographic parameters and clinical risk factors predicting postoperative respiratory complications in children undergoing supraglottoplasty. J Clin Sleep Med. 2024;20(1):9-16.

Keywords: OSA; desaturation; infant apnea; laryngomalacia; polysomnography; postoperative respiratory complications; supraglottoplasty.

PubMed Disclaimer

Conflict of interest statement

All authors have seen and approved the manuscript. The project was supported by the Cincinnati Children’s Research Foundation. The authors report no conflicts of interest.

References

    1. Daniel SJ . The upper airway: congenital malformations . Paediatr Respir Rev. 2006. ; 7 ( Suppl 1 ): S260 – S263 . - PubMed
    1. Smith GJ, Cooper DM . Laryngomalacia and inspiratory obstruction in later childhood . Arch Dis Child. 1981. ; 56 ( 5 ): 345 – 349 . - PMC - PubMed
    1. Tanphaichitr A, Tanphaichitr P, Apiwattanasawee P, Brockbank J, Rutter MJ, Simakajornboon N . Prevalence and risk factors for central sleep apnea in infants with laryngomalacia . Otolaryngol Head Neck Surg. 2014. ; 150 ( 4 ): 677 – 683 . - PubMed
    1. Zafereo ME, Taylor RJ, Pereira KD . Supraglottoplasty for laryngomalacia with obstructive sleep apnea . Laryngoscope. 2008. ; 118 ( 10 ): 1873 – 1877 . - PubMed
    1. Olney DR, Greinwald JH Jr, Smith RJ, Bauman NM . Laryngomalacia and its treatment . Laryngoscope. 1999. ; 109 ( 11 ): 1770 – 1775 . - PubMed