title: Characterization of supraglottic phonation in children after airway reconstruction.
abstract: OBJECTIVE
  We examined select acoustic (signal type), aerodynamic, and perceptual measures and associated surgical data in a cohort of children who were endoscopically identified as using supraglottic phonation after undergoing airway reconstruction.
  
  
  METHODS
  Twenty-one children (4 to 18 years of age) who were seen in the Cincinnati Children's Hospital Medical Center for Pediatric Voice Disorders and identified as using supraglottic phonation were included in this study. According to standard protocol, each of these children underwent acoustic, aerodynamic, and perceptual analyses and laryngeal imaging. Their medical records were reviewed for surgical history.
  
  
  RESULTS
  Four primary supraglottic compression patterns and 3 distinct sound sources for voice were identified. Signal type classification revealed that 20 of 21 voice signals were either type II or type III. Signal type was moderately associated with compression pattern (p = 0.01). No statistically significant findings were found in testing the Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) Overall Severity score against compression patterns and vibration source. The mean Strain scores for participants who used a combined source of vibration were significantly higher than for those who used their ventricular folds.
  
  
  CONCLUSIONS
  The compensatory compression patterns and alternate sources of vibration used by these children resulted in moderate to severe dysphonias. How children compensate after undergoing airway reconstruction has important implications for behavioral and surgical interventions aimed at improving voice quality. Not all aspects of traditional voice evaluation are suitable for this population.
authors.affiliation: Center for Pediatric Voice Disorders, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Kelchner
authors.forename: Barbara
authors.initials: B
authors.lastname: Weinrich
authors.forename: Susan Baker
authors.initials: SB
authors.lastname: Brehm
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Tabangin
authors.forename: Alessandro
authors.initials: A
authors.lastname: de Alarcon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007829:Laryngostenosis / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D010699:Phonation; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D049489:Stroboscopy; D014732:Vibration; D014833:Voice Quality