This is a patient with persistant laryngomalacia with stridor and Obstructive sleep apnea at 3 years of age. A flexible laryngoscopy showed prolapse of epiglottis into the airway. The patient had nasotracheal intubation and a suture was place through the anterior tongue to pull it forward while a modified McIvor mouth gag was placed with a short blade to expose the tongue base and epiglottis. The DaVinci robot is then docked with a 30 degree forward lens. A 5mm maryland forceps and a 5 mm bovie is used.The epithelium off the tongue base and the lingual surface of epiglottis is then denuded with a bovie at a setting of 10 after this is done the epiglottis is sutured to the tongue base with a 4.0 vicryl suture. A total of two or three sutures are placed with 3-4 knots on each suture. The patient is extubated and monitered overnight with 2-3 doses of Steroids.
DOI: http://dx.doi.org/10.17797/z6vqam37jc
Review Pediatric Robotic Epiglottopexy.