(1031) Prognostic Outcomes for Suprastomal Granuloma Treatment: A Systematic Review and Meta-Analysis

Introduction: Suprastomal granuloma (SSG) is a clinically important tracheostomy-related complication that may contribute to airway obstruction, impair capping tolerance, and delay decannulation in children. Our primary aim is to systematically evaluate pooled outcomes of surgical and non-surgical interventions for SSG, focusing on decannulation success and post-treatment sequelae

Methods: A systematic search of PubMed, Web of Science, and ScienceDirect was performed from database inception through October 2025. Studies reporting treatment outcomes following surgical and/or non-surgical management of SSG were included. Pooled event rates were calculated using a random-effects meta-analysis of proportions and reported as pooled rates with 95% confidence intervals.

Results: Of 786 records, 12 studies were included, comprising 394 patients with SSG. Following surgical management, pooled successful decannulation was 61.3% (95% CI 41.8–77.8), and pooled voice production was 71.7% (95% CI 47.1–87.8). Recurrence at follow-up 34.8% (95% CI 22.4–49.6), and suprastomal collapse 29.9% (95% CI 5.5–75.6). Following non-surgical interventions, pooled successful decannulation 95.2% (95% CI 60.8–99.6). Persistence of SSG at follow-up 44.2% (95% CI 28.9–60.7), with spontaneous resolution 55.8% (95% CI 39.3–71.1). Suprastomal collapse in the non-surgical group 52.2% (95% CI 32.5–71.2).

Conclusions: Surgical treatment of SSG demonstrates moderate pooled decannulation success, with recurrence in approximately 1/3 of patients, whereas non-surgical strategies show high pooled decannulation rates. Overall, there were no statistically significant differences in outcomes the two SSG groups. This lack of treatment advantage of one over the other can be due to case-by-case treatment selection, with mores severe SSG more often requiring surgery.N/A