Fifteen-minute consultation: structured approach to management of a child with recurrent croup

Recurrent croup and persistent laryngomalacia: Clinical resolution after supraglottoplasty

OBJECTIVES

To determine if children with recurrent croup (RC) and persistent laryngomalacia (LM) clinically improve after supraglottoplasty (SGP).

MATERIAL AND METHODS

Retrospective chart review cohort at tertiary care children's hospital consisting of patients diagnosed with LM and RC that underwent SGP from July 2011 to August 2014. Clinical history, demographics, clinical outcomes, and operative complications were reviewed. Specifically, the episodes of croup requiring systemic steroids were compared pre- and post-SGP with statistical analysis.

RESULTS

Out of 107 patients undergoing SGP for LM, 6 patients (5.6%) were diagnosed with RC. Mean age at first croup episode was 11.5 months. Mean age at SGP was 4.3 years. Mean number of emergency department visits was 3.2 (range 2-6 visits) prior to SGP. Mean number of episodes of croup requiring systemic steroids before and after SGP was 9.8 vs. 0.2 (p=0.003). Mean length of followup after SGP was 30.5 months (range 18-46 months). There were no surgical postoperative complications.

CONCLUSIONS

This is the first series to describe the clinical resolution of croup episodes in children with LM corrected by SGP. Recurrent croup should be added among other conditions associated with late-onset or persistent laryngomalacia.