title: Quality of life and voice outcomes after thyroid ala graft laryngotracheal reconstruction in young children.
abstract: OBJECTIVE
  (1) To assess the long-term impact of thyroid ala cartilage laryngotracheal reconstruction (TAC-LTR) on health-related quality of life (QOL) in infants using 4 validated instruments: Health Utility Index version 3 (HUI3), Pediatric Voice-Related QOL (PVRQOL), Impact on Family Questionnaire, and a visual analog scale and (2) to perform acoustic and perceptual voice assessments to evaluate longterm voice quality outcomes.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Tertiary academic pediatric hospital.
  
  
  METHODS
  Eligible children who received TAC-LTR before the age of 24 months between 1995 and 2007.
  
  
  METHODS
  Interviews with parents and children using 4 validated instruments, voice analyses, and endoscopic evaluation were performed.
  
  
  RESULTS
  Twelve patients (7 male, 5 female, median age 10 years) were enrolled over a 6-month period. The mean age at LTR was 5 months (range, 1-20 months), and the mean study followup period was 9 years (range, 2-14 years). The average speech HUI3, PVRQOL, and Impact on Family scores were 0.83 (95% confidence interval = 0.74, 0.92), 0.93 (interquartile range [IQR] = 0.81, 1.00), and 0.65 (IQR = 0.54, 0.92), respectively. All acoustic scores were either normal or mildly abnormal for the variables jitter, shimmer, noise-to-harmonic ratio, peak amplitude variation, and fundamental frequency. The Consensus Auditory-Perceptual Evaluation of Voice overall severity score was in the normal to mildly abnormal range for 8 of 9 patients.
  
  
  CONCLUSIONS
  This is the first study to explore and quantify longterm QOL and voice quality in children following LTR with thyroid ala graft at a very young age. Most patients had very good functional voice outcome as evidenced by the HUI3 and PVRQOL scores. This was corroborated by acoustic and perceptual voice assessments.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
authors.forename: Yamilet
authors.initials: Y
authors.lastname: Tirado
authors.forename: Neil K
authors.initials: NK
authors.lastname: Chadha
authors.forename: Jennifer
authors.initials: J
authors.lastname: Allegro
authors.forename: Vito
authors.initials: V
authors.lastname: Forte
authors.forename: Paolo
authors.initials: P
authors.lastname: Campisi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007830:Larynx / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D013957:Thyroid Cartilage / Q000637:transplantation*; D014132:Trachea / Q000601:surgery*; D016896:Treatment Outcome; D014833:Voice Quality