Laser supraglottoplasty: development of an outcomes tool

摘要

Laryngomalacia is a common cause of airway obstruction in neonates and infants that, when severe, may be treated surgically via laser supraglottoplasty. Despite individual surgeons' successful experience with this technique, an objective broadly applied assessment of patient outcomes has been lacking. This is worrisome since the provision of health care is increasingly judged by the ultimate result: whether a persons' quality of life is better for having undergone a particular procedure. Institutions that lack evidence of such benefit will face difficulty in justifying, and in obtaining compensation for, their services. We share our tool for the measurement of outcomes following laser supraglottoplasty. Over the past year, we have found this tool to be easily and rapidly applied. The wide range of possible combinations of patient presentation and the specific anatomic conformation of the laryngomalacia are effectively organized into standard database format, allowing for relevant clinical and anatomic information to be compared to post-operative indicators of outcome. We hope that this discussion prompts the development of similar tools for patient assessment following other laser airway procedures. Our ability as health care providers to control patient care depends upon the presentation of cogent, convincing evidence of improved patient well-being following treatment.