title: Dysphonia secondary to traumatic avulsion of the vocal fold in infants.
abstract: OBJECTIVE
  Airway compromise due to paediatric intubation injuries is well documented; however, intubation injuries may also cause severe voice disorders. We report our experience and review the world literature on the voice effects of traumatic paediatric intubation.
  
  
  METHODS
  We report five cases of children referred to Great Ormond Street Hospital for Children who suffered traumatic avulsion of the vocal fold at the time of, or secondary to, endotracheal intubation. All children had significant dysphonia and underwent specialist voice therapy.
  
  
  CONCLUSIONS
  The mechanisms of injury, risk factors and management of the condition are discussed. Children suffering traumatic intubation require follow up throughout childhood and beyond puberty as their vocal needs and abilities change. At the time of writing, none of the reported patients had yet undergone reconstructive or medialisation surgery. However, regular specialist voice therapy evaluation is recommended for such patients, with consideration of phonosurgical techniques including injection laryngoplasty or thyroplasty.
authors.affiliation: Department of Paediatric Otolaryngology, Great Ormond Street Hospital for Children, London, UK. dbray@doctors.org.uk
authors.forename: D
authors.initials: D
authors.lastname: Bray
authors.forename: L
authors.initials: L
authors.lastname: Cavalli
authors.forename: N
authors.initials: N
authors.lastname: Eze
authors.forename: N
authors.initials: N
authors.lastname: Mills
authors.forename: B E J
authors.initials: BE
authors.lastname: Hartley
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007820:Laryngeal Mucosa / Q000293:injuries / Q000473:pathology; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D012121:Respiration, Artificial / Q000009:adverse effects; D013070:Speech Therapy; D013071:Speech, Alaryngeal; D055090:Tracheomalacia / Q000150:complications; D014139:Tracheostomy / Q000009:adverse effects; D016896:Treatment Outcome; D014827:Vocal Cords / Q000293:injuries*; D014832:Voice Disorders / Q000209:etiology* / Q000628:therapy