Cross-sectional follow up of voice outcomes in children who have a history of airway reconstruction surgery

Cohen, Wendy and Wynne, David M and Lloyd, Susan and Townsley, Richard B (2017) Cross-sectional follow up of voice outcomes in children who have a history of airway reconstruction surgery. Clinical Otolaryngology. ISSN 1749-4478

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    Abstract

    Objectives - This study reports vocal function in a cross-section of children with subglottic stenosis. Each child had a history of laryngotracheal reconstruction and/or cricotracheal resection surgery. Vocal function was measured using laryngoscopy, acoustic analysis, perceptual evaluation and impact of voice on quality of life.  Design - All patients aged >5 years with history of laryngotracheal reconstruction and/or cricotracheal resection surgery at the Scottish National Complex Airways service were invited to participate.  Setting - Data was gathered in the Royal Hospital for Children in Glasgow in a single out-patient appointment. Participants - Twelve out of fifty-six former patients (aged 5 – 27) provided a voice sample and eleven consented to awake laryngoscopy. All consented for detailed evaluation of their medical records.  Main outcome measures - Acoustic analysis of fundamental frequency and pitch perturbation was conducted on sustained vowel [a]. Perceptual evaluation was conducted by four trained listeners on a series of spoken sentences. Impact on quality of life was measured using the Paediatric Voice Related Quality of Life questionnaire. Laryngeal function was descriptively evaluated.  Results - Four children had normal voice acoustically, perceptually and in relation to voice related quality of life. One of these had vocal fold nodules unrelated to surgical history. Two other children had ‘near normal’ vocal function, defined where most voice measurements fell within the normal range.  Conclusions - Normal or ‘near normal’ voice is a possible outcome for children who have had this surgery. Where there is an ongoing complex medical condition, voice outcome may be poorer.