What Is Supraglottoplasty?

Medically Reviewed by Dan Brennan, MD on July 24, 2022
4 min read

Supraglottoplasty is a procedure usually performed on children to treat laryngomalacia — a condition that obstructs a person’s airway. It may also be performed on adults and is usually regarded as a safe and simple procedure. 

Here’s what you need to know.

Supraglottoplasty is a surgical procedure that aims to remove excess tissue from the voice box. Usually performed during childhood, it results in easier breathing, treating nosy breathing and obstructive sleep apnea. Although supraglottoplasty isn’t very common, it can be the perfect solution for children with excess tissue in the upper larynx.

The larynx is a tube located in your neck that allows air to pass from your throat to your lungs. Containing the vocal cords, it plays a crucial part in human speech while also preventing food from getting into your respiratory system. Yet, sometimes, excess tissue can form in the upper larynx, causing interference in a baby’s breathing.

Despite what one might think, supraglottoplasty is a relatively simple and safe procedure, usually taking about an hour. The child will be placed under general anesthesia, and little to no preparation is needed for the surgery. Similarly, it generally doesn’t cause any post-procedure complications apart from some swelling.

Supraglottoplasty may benefit anyone who presents an obstruction in the larynx, be they a child or an adult. For example, this procedure can be used to treat obstructive sleep apnea — a condition that causes interruptions in a person’s breathing pattern during sleep. However, the most common condition that’s treated with the supraglottoplasty surgery is, by far, laryngomalacia.

Laryngomalacia is a condition that causes an obstruction in the larynx due to excessive floppy tissue. When a baby with laryngomalacia breathes in, the tissue in the upper voice box falls in, blocking the child’s airway. This causes difficulty breathing and a characteristic squeaky noise when the person is taking in air — a sound commonly known as stridor.

While laryngomalacia usually improves on its own during the first year of a baby’s life, supraglottoplasty may sometimes be necessary. With this procedure, surgeons tighten and remove excess tissue in the upper larynx, reducing the stridor and breathing difficulties.

The supraglottoplasty procedure is a rather simple and short surgery, usually taking around an hour. While your doctor will probably inform you of what the team will do, it’s always a good idea to know a bit about the procedure before the first visit to the hospital. 

Before the surgery begins, an expert will put the child under general anesthesia

The doctor will then insert a laryngoscope into the throat to confirm the diagnosis and ensure that a supraglottoplasty is indeed needed. A laryngoscope is a thin tube that allows doctors to look closely at the larynx using light, lenses, and a video camera. 

If the diagnosis is confirmed, the surgeon will perform simple incisions on the folds of the larynx to tense the tissues of the voice box. This is done on both sides, accompanied by specific medications to prevent bleeding and other tissue reactions that may disturb the surgery. Sometimes, laser burns are needed for a successful operation — a technique known as epiglottopexy.

Once the procedure is done, the staff will remove the tubes from the child and sometimes recommend spending the night at a high-care unit. No further procedures are needed most of the time, although some children may need a follow-up in specific cases. 

The same steps apply in the rarer case when this procedure is performed on an adult. 

While supraglottoplasty is a relatively safe and simple procedure, it carries, like most surgeries, certain risks, including potential complications. Still, many of these can be avoided or reduced by following the guidelines provided by the doctors concerning post-operative care. 

Here are some of the complications that may stem from the supraglottoplasty procedure:

It’s also important to keep in mind that there are some underlying conditions that may result in a lack of improvement after a supraglottoplasty. Most noticeably, acid reflux symptoms are associated with a failure to improve. Similarly, neurological conditions such as severe autism or Angelman syndrome are also linked to unsuccessful surgeries.

While these conditions don’t necessarily mean that the procedure will go wrong, they may warrant a second intervention to ensure improvement. This may help the doctors diagnose an underlying, previously unnoticed condition.

When considering a supraglottoplasty, you should first try to get a second opinion — laryngomalacia usually goes away on its own after some time, so surgery can sometimes be avoided. Once you’re sure that the procedure is unavoidable, take your time getting comfortable with the doctors and the hospital itself.

Before the surgery takes place, doctors will instruct the patient to avoid food, drinks, and medications for a set amount of time. If the child has symptoms of acid reflux, they may treat that first to avoid unnecessary complications.

Swelling and pain are common during the first week of recovery — it may last even longer depending on the severity of the condition. Doctors may choose to treat post-surgery pain and acid reflex with specific medications.

If you’re having any doubts, make sure to discuss them with the surgeon before the procedure. Whether it’s you or your child that’s being operated on, staying calm and confident is a crucial part of any surgery and optimal recovery.