title: Subjective and objective parameters of the adult female voice after cricotracheal resection and dilation.
abstract: OBJECTIVE
  We compared the voice outcomes after cricotracheal resection (CTR) and airway dilation in adult women.
  
  
  METHODS
  We performed long-term comprehensive voice assessments in 23 adult women treated for laryngotracheal stenosis, including acoustic and perceptual measurements of voice, videostroboscopy, the Voice Handicap Index, and an open-ended subjective questionnaire.
  
  
  RESULTS
  Voice measures were abnormal in both groups. Objective pitch and loudness measurements were significantly more impaired after CTR than after dilation. Perceptual ratings of voice were worse after CTR than after dilation, particularly with regard to breathiness, pitch, and loudness. The CTR group was more likely to report a voice disorder, reported significantly more voice symptoms, and had higher voice handicap scores. Videostroboscopy was frequently abnormal in both groups, with more evidence of vocal hyperfunction after CTR. Self-ratings of breathing and swallowing were generally high in both groups, but voice satisfaction was rated lower after CTR.
  
  
  CONCLUSIONS
  Voice was more significantly negatively impacted by CTR than by dilation. Surprisingly, many individuals in both groups reported improvements--a finding that possibly highlights the impact of laryngotracheal stenosis on airflow and vocal function before surgery. The importance of patient selection and preoperative counseling is emphasized, along with the potential need for voice therapy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Northwest Clinic for Voice and Swallowing, Oregon Health and Science University, Portland, OR 97239, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Bryans
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Northwest Clinic for Voice and Swallowing, Oregon Health and Science University, Portland, OR 97239, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Palmer
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Northwest Clinic for Voice and Swallowing, Oregon Health and Science University, Portland, OR 97239, USA.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Schindler
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR 97239, USA.
authors.forename: Peter E
authors.initials: PE
authors.lastname: Andersen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR 97239, USA.
authors.forename: James I
authors.initials: JI
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003413:Cricoid Cartilage / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007829:Laryngostenosis / Q000601:surgery*; D008875:Middle Aged; D009922:Oregon / Q000453:epidemiology; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000601:surgery*; D014832:Voice Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D014833:Voice Quality; D055815:Young Adult