title: Compensatory laryngeal function and airway protection in children following airway reconstruction.
abstract: OBJECTIVE
  Laryngotracheal reconstruction (LTR) procedures for repair of complex congenital or acquired airway stenosis of the larynx and/or trachea in pediatric patients have advanced over recent decades. The aim of the present project was to investigate the relationships among diagnoses, type of surgical intervention, and laryngeal findings in a post-LTR patient cohort to identify factors associated with adequate airway protection and swallowing outcomes.
  
  
  METHODS
  A retrospective review of 30 airway patients undergoing simultaneous or close interval functional laryngeal and swallowing examinations was completed. Analyses of the data were performed to examine factors associated with postoperative airway protection and swallowing function. The patient cohort was separated into 2 groups according to the adequacy of their airway protection (aspiration and no aspiration) as judged by clinicians via instrumental examination.
  
  
  RESULTS
  Data analyses revealed statistically significant differences between the 2 groups for 3 key parameters: laryngeal closure, laryngeal closure timeliness (relative to bolus flow), and overall swallowing coordination.
  
  
  CONCLUSIONS
  These findings contribute to the knowledge of laryngeal closure patterns present in patients undergoing airway reconstruction and the effect on the essential laryngeal function of airway protection during swallowing. Implications of the data for swallowing function in this population are discussed.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Division of Speech Pathology/Aerodigestive and Esophageal Center, Cincinnati, Ohio, USA.
authors.forename: Claire Kane
authors.initials: CK
authors.lastname: Miller
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Kelchner
authors.forename: Alessandro
authors.initials: A
authors.lastname: de Alarcon
authors.forename: J Paul
authors.initials: JP
authors.lastname: Willging
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003679:Deglutition / Q000502:physiology; D005260:Female; D006801:Humans; D007829:Laryngostenosis / Q000601:surgery*; D007830:Larynx / Q000502:physiology*; D008297:Male; D010699:Phonation / Q000502:physiology; D011184:Postoperative Period; D019651:Plastic Surgery Procedures; D053120:Respiratory Aspiration / Q000503:physiopathology; D012189:Retrospective Studies; D014135:Tracheal Stenosis / Q000601:surgery*; D055815:Young Adult
keywords: airway protection; aspiration; dysphagia; laryngotracheal reconstruction