Laryngeal reconstruction in children. Assessment of vocal quality.
During the past decade, the outcome of laryngotracheal reconstruction in children has improved substantially regarding airway patency. Now that we feel comfortable with airway results, attention should be directed toward vocal quality. The aims of this article are to present our evaluation process, which has been developed during the past 3 years, and our assessment of results. Six patients who underwent successful laryngotracheal reconstruction and could be examined preoperatively and postoperatively were studied. Information about disease and reconstruction techniques was recorded. Vocal quality assessment was done using psychoacoustic evaluation and objective techniques, including acoustic analysis. Children offer a specific challenge, especially when their chronological or developmental age is younger than 3 years. Objective assessment still lacks the ability of using cooperative patients, and adequate samples for acoustic analysis are difficult to obtain and standardize. Preoperative abnormalities continued to persist postoperatively. Laryngotracheal reconstruction is instrumental in making oral communication possible, but the vocal quality is disturbed in most patients.
Zalzal
G H
GH
Department of Pediatric Otolaryngology, Children's National Medical Center, Washington, DC 20010.
Loomis
S R
SR
Fischer
M
M
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007818:Laryngeal Diseases / Q000601:surgery; D007830:Larynx / Q000601:surgery*; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D010609:Pharyngeal Muscles / Q000503:physiopathology; D010699:Phonation / Q000502:physiology; D011571:Psychoacoustics; D012123:Pulmonary Ventilation / Q000502:physiology; D014132:Trachea / Q000601:surgery; D014140:Tracheotomy / Q000534:rehabilitation; D014827:Vocal Cords / Q000503:physiopathology; D014831:Voice / Q000502:physiology; D014832:Voice Disorders / Q000209:etiology / Q000503:physiopathology; D014833:Voice Quality / Q000502:physiology*