The Prevalence of Dysphagia in Children with Laryngomalacia Pre and Postsupraglottoplasty: A Systematic Review with Meta-Analysis

Rossoni, Eduarda Pinto; Miranda, Vanessa Souza Gigoski de; Barbosa, Lisiane De Rosa

doi:10.1055/s-0042-1755309

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Brasil

International Archives of Otorhinolaryngology

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Brasil

Español English

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Systematic Review • iao 28 (1) • 2024 • https://doi.org/10.1055/s-0042-1755309 copy

The Prevalence of Dysphagia in Children with Laryngomalacia Pre and Postsupraglottoplasty: A Systematic Review with Meta-Analysis

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Laryngomalacia is the most common congenital laryngeal alteration, with spontaneous resolution in most cases. However, in the face of more severe presentations of the disease, it is necessary to perform supraglottoplasty surgery. Studies have been dedicated to researching changes in swallowing in children with laryngomalacia before and after surgical intervention.

Objectives

To identify the prevalence of oropharyngeal dysphagia in children with pre and postsupraglottoplasty laryngomalacia.

Data Synthesis

A search strategy was developed with terms and entreterms to designate a population pediatric with laryngomalacia, exposure supraglottoplasty, and outcome frequency of dysphagia, adapted to the requirements of the main databases in the health area. The analysis of the records found was performed by two independent examiners and, in the end, 6 articles were included in the study. The articles found enabled a sample of 330 children with laryngomalacia, 311 of whom underwent supraglottoplasty. Among the included studies, 5 were grouped and meta-analyzed. After supraglottoplasty surgery, a 59% reduction in the prevalence of oropharyngeal dysphagia was identified, with high heterogeneity I² = 93%.

Conclusion

Despite the heterogeneity of the sample, the supraglottoplasty procedure significantly reduces the prevalence of dysphagia in children with laryngomalacia.

Keywords
infant; newborn; deglutition; deglutition disorders; laryngomalacia; aspiration

Study, year	Type of study	(n)* with LM*	(n)* with SGP	Average age (days)	Associated comorbidities	Assessment
Richter et al., 2009²⁰20 Richter GT, Rutter MJ, deAlarcon A, Orvidas LJ, Thompson DM. Late-onset laryngomalacia: a variant of disease. Arch Otolaryngol Head Neck Surg 2008;134(01):75–80. Doi: 10.1001/archoto.2007.17 https://doi.org/10.1001/archoto.2007.17...	Cross-sectional	50	50	136	GERD, congenital heart disease, neurological disease, genetic disease.	VED
Rastatter et al., 2010²¹21 Rastatter JC, Schroeder JW, Hoff SR, Holinger LD. Aspiration before and after Supraglottoplasty regardless of Technique. Int J Otolaryngol 2010;2010:912814. Doi: 10.1155/2010/912814 https://doi.org/10.1155/2010/912814...	Cross-sectional	39	39	48	Prematurity	VFSS
Powitzky et al., 2011²²22 Powitzky R, Stoner J, Fisher T, Digoy GP. Changes in sleep apnea after supraglottoplasty in infants with laryngomalacia. Int J Pediatr Otorhinolaryngol 2011;75(10):1234–1239. Doi: 10.1016/j.ijporl.2011.06.021 https://doi.org/10.1016/j.ijporl.2011.06...	Cross-sectional	20	20	118.6	Translocation of chromosome 9 and 15, myasthenia gravis, down syndrome, tracheomalacia, micrognathia, macroglossia, glottic stenosis	VFSS
Durvasula et al., 2013²³23 Durvasula VSPB, Lawson BR, Bower CM, Richter GT. Supraglottoplasty in premature infants with laryngomalacia: does gestation age at birth influence outcomes? Otolaryngol Head Neck Surg 2014;150(02):292–299	Cross-sectional	176	176	129.8	Tracheomalacia, bronchomalacia, laryngeal edema, unilateral vocal fold paralysis, subglottic stenosis, laryngeal cleft, prematurity	VFSS
Givens et al., 2018²⁴24 Givens V, Brent K, Dunham M, Kanotra SP. Cricopharyngeal achalasia associated with laryngomalacia as a cause of failure to thrive. J Laryngol Otol 2018;132(09):852–855	Case Study	1	1	121	GERD, bronchiolitis, and pneumonia, cricopharyngeal achalasia	VFSS e VED
Scott et al., 2019²⁵25 Scott BL, Lam D, MacArthur C. Laryngomalacia and swallow dysfunction. Ear Nose Throat J 2019;98(10):613–616	Cross-sectional	44	25	96	Down syndrome, genetic syndrome, neuromuscular disorder, prematurity, craniofacial anomaly, GERD, asthma, congenital anomaly of the heart and lung, anomaly of the upper airways.	VFSS

Study, year	Dysphagia pre	Dysphagia post
Richter et al., 2009²⁰20 Richter GT, Rutter MJ, deAlarcon A, Orvidas LJ, Thompson DM. Late-onset laryngomalacia: a variant of disease. Arch Otolaryngol Head Neck Surg 2008;134(01):75–80. Doi: 10.1001/archoto.2007.17 https://doi.org/10.1001/archoto.2007.17...	44	8
Rastatter et al., 2010²¹21 Rastatter JC, Schroeder JW, Hoff SR, Holinger LD. Aspiration before and after Supraglottoplasty regardless of Technique. Int J Otolaryngol 2010;2010:912814. Doi: 10.1155/2010/912814 https://doi.org/10.1155/2010/912814...	10	21
Powitzky et al., 2011²²22 Powitzky R, Stoner J, Fisher T, Digoy GP. Changes in sleep apnea after supraglottoplasty in infants with laryngomalacia. Int J Pediatr Otorhinolaryngol 2011;75(10):1234–1239. Doi: 10.1016/j.ijporl.2011.06.021 https://doi.org/10.1016/j.ijporl.2011.06...	7	9
Durvasula et al., 2013²³23 Durvasula VSPB, Lawson BR, Bower CM, Richter GT. Supraglottoplasty in premature infants with laryngomalacia: does gestation age at birth influence outcomes? Otolaryngol Head Neck Surg 2014;150(02):292–299	109	22
Givens et al., 2018²⁴24 Givens V, Brent K, Dunham M, Kanotra SP. Cricopharyngeal achalasia associated with laryngomalacia as a cause of failure to thrive. J Laryngol Otol 2018;132(09):852–855	1	0
Scott et al., 2019²⁵25 Scott BL, Lam D, MacArthur C. Laryngomalacia and swallow dysfunction. Ear Nose Throat J 2019;98(10):613–616	25	2

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[1] Address for correspondence Vanessa Gigoski de Miranda, Master in Pneumological Sciences, Av. Família Gonçalves Carneiro, 441,12, 201. Postal Code: 91920250, Brazil (email: vanessa_gigoski@hotmail.com).

(#1) Patient	Infant [Mesh] OR Infants OR Infant, Newborn [Mesh] OR Infants, Newborn OR Newborn Infant OR Newborn Infants OR Newborns OR Newborn OR Neonate OR Neonates
(#2) Exposure	Tracheobronchomalacia [MESH] OR Tracheobronchomalacias OR Laryngomalacia [MESH] OR Laryngomalacias OR Chondromalacia of Larynx OR Larynx Chondromalacia OR Larynx Chondromalacias OR Cartilage Diseases [MESH] OR Cartilage Disease OR Chondromalacia OR Chondromalacias OR Laryngeal Diseases [MESH] OR Disease, Laryngeal OR Diseases, Laryngeal OR Laryngeal Disease OR Larynx Diseases OR Disease, Larynx OR Diseases, Larynx OR Larynx Disease” OR Laryngeal Perichondritis OR Laryngeal Perichondritis OR Perichondritis, Laryngeal OR Perichondritis, Laryngeal OR Bronchomalacia [MESH] OR Bronchomalacias OR Chondromalacia of Bronchi OR “Bronchi Chondromalacia OR Bronchi Chondromalacias” OR Tracheomalacia [MESH] OR Tracheomalacias OR Chondromalacia of Trachea OR Trachea Chondromalacia OR Trachea Chondromalacias
(#3) Outcome	Respiratory Aspiration OR Pneumonia, Aspiration OR Deglutition Disorders
Search	*#1 AND #2 AND #3*