{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:42:48Z","timestamp":1760985768106,"version":"3.40.5"},"reference-count":11,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,12,25]],"date-time":"2018-12-25T00:00:00Z","timestamp":1545696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Epiglottic petiole prolapse is an overlooked entity that could lead to supraglottic airway obstruction for patients with complex airway history. Classical symptoms include exercise intolerance, obstructive sleep apnea, and difficulty with decannulation. The goal of this project was to evaluate the factors associated with epiglottic petiole repositioning success.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective case series of patients with a complex history of airway reconstruction evaluated by the aerodigestive team at a tertiary pediatric hospital from May 2003 to August 2017. All patients underwent repositioning for petiole prolapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We had a total of 59 patients (14 females, 23.7%) with complex airway anomalies with petiole prolapse noted during a microlaryngoscopy and bronchoscopy. Mean age was 12.9 \u00b1 6.1 year old (range 1.3\u201335.9). Patients had a history of 2.2 (1\u20135) open airway surgeries, and 51 of 58 (87.9%) of them had a prior complete laryngofissure. Laryngotracheoplasty and petiole repositioning were performed as a double\u2010stage surgery for 54 of 58 (91.5%) patients. Epiglottic petiole prolapse was persistent in 20 patients (33.9%) and became symptomatic for 14 of them (23.7%). The main preventive factor of petiole prolapse recurrence was pre\u2010epiglottic fat debulking at the time of the repositioning, with an odds ratio of 0.06 (95% confidence interval 0.007\u20130.6, <jats:italic>P =<\/jats:italic> 0.01). Stent placement, longer duration of stent placement, and double\u2010stage procedure also increased the likelihood of success (all <jats:italic>P<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with petiole prolapse have a history of complete laryngofissure and multiple open airway surgeries. Pre\u2010epiglottic fat debulking and longer stent placement at the time of the repositioning surgery appear to significantly increase the long\u2010term success rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4<\/jats:p><jats:p><jats:italic>Laryngoscope<\/jats:italic>, 129:1984\u20131988, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27705","type":"journal-article","created":{"date-parts":[[2018,12,26]],"date-time":"2018-12-26T07:05:10Z","timestamp":1545807910000},"page":"1984-1988","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Factors associated with epiglottic petiole prolapse repositioning success"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8300-3220","authenticated-orcid":false,"given":"Mathieu","family":"Bergeron","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery  Cincinnati OH U.S.A."},{"name":"Department of Pediatric Otolaryngology\u2013Head and Neck Surgery Sainte\u2010Justine Hospital, University of Montreal  Montreal, Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4792-4676","authenticated-orcid":false,"given":"Alessandro","family":"de Alarcon","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery  Cincinnati OH U.S.A."},{"name":"the Aerodigestive and Esophageal Center Cincinnati Children's Hospital Medical Center  Cincinnati OH U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University Of Cincinnati College of Medicine  Cincinnati OH U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0670-9937","authenticated-orcid":false,"given":"Catherine K","family":"Hart","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery  Cincinnati OH U.S.A."},{"name":"the Aerodigestive and Esophageal Center Cincinnati Children's Hospital Medical Center  Cincinnati OH U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University Of Cincinnati College of Medicine  Cincinnati OH U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Rutter","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery  Cincinnati OH U.S.A."},{"name":"the Aerodigestive and Esophageal Center Cincinnati Children's Hospital Medical Center  Cincinnati OH U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University Of Cincinnati College of Medicine  Cincinnati OH 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