Postoperative observation of children after endoscopic type 1 posterior laryngeal cleft repair

Nathan S. Alexander, Judy Z. Liu, Bharat Bhushan, Lauren D. Holinger, James W. Schroeder*

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Objectives. To report the perioperative management and surgical outcomes in a large series of pediatric patients with endoscopically repaired type 1 posterior laryngeal cleft (PLC). Study Design. Case series with chart review. Setting. Urban, tertiary care, free-standing pediatric hospital. Subjects and Methods. Patients who underwent endoscopic carbon dioxide laser-assisted repair of type 1 posterior laryngeal clefts between January 2006 and December 2012. Medical records were reviewed. Results. Fifty-four patients (34 male) underwent repair of type 1 PLC. Median age was 25.5 months (range, 2-120 months). Indications for repair included aspiration (n = 39; 72%), chronic bronchitis (n = 13; 24%), and stridor with feeds (n = 2; 4%). No children remained intubated postoperatively. Thirty-three patients (61%) stayed in overnight observation ("Obs PLC") and 21 patients (39%) stayed in the pediatric intensive care unit ("PICU PLC") postoperatively. Between Obs PLC and PICU PLC groups, there was no significant difference in age (mean 22 vs 30 months, respectively; P = .28). Comorbidities were similar between the groups. Symptoms improved in 41 of the 54 patients (76%). No postoperative complications were noted. Two patients required revision PLC repair. The cost of admitting a patient to a lower acuity location was estimated to be 60% less per day than cost of a PICU admission. Conclusions. The endoscopic surgical repair of a type 1 PLC is successful and has a low morbidity and complication rate. Patients may be safely managed in an observation unit and without postoperative intubation. This approach achieved a marked cost reduction in postoperative care.

Original languageEnglish (US)
Pages (from-to)153-158
Number of pages6
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume152
Issue number1
DOIs
StatePublished - Jan 31 2015

Keywords

  • aspiration
  • dysphagia
  • posterior laryngeal cleft

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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