title: Dysphonia in extremely preterm children: A longitudinal observation.
abstract: BACKGROUND
  Dysphonia is a potential long-term complication of preterm birth. Childhood voice disorders caused by vocal hyperfunction resolve with pubertal changes to the vocal mechanism in many cases. In extremely preterm children, whose voice quality is affected by supraglottic hyperfunction adapted secondary to underlying structural laryngeal pathology sustained during neonatal intubation, the prognosis is unknown.
  
  
  METHODS
  A pilot study was conducted to assess the incidence and severity of dysphonia in children born at < 25 weeks' gestation. Ten individuals, aged between 9.67 and 17.08 years, presented for repeat assessment in a replication and extension of the original study. The mean period between assessments was 2.85 (SD 0.38) years. The primary outcome measure was the severity score on the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), with the Acoustic Voice Quality Index score as the secondary outcome measure. Scores on the Pediatric Voice Handicap Index were also compared.
  
  
  RESULTS
  Perceptual dysphonia severity scores were significantly lower on repeat assessment, but no differences were observed in objective or quality of life scores. Individual variation was observed: the difference in CAPE-V scores ranged from -36 to + 1. No participant presented with normal voice quality on repeat assessment.
  
  
  CONCLUSIONS
  Analysis of group data masked individual variability in this series. Mechanisms underlying such individual variation are currently unknown. These data suggest that dysphonia is persistent in extremely preterm children.
  
  
  CONCLUSIONS
  Further investigation is warranted to elucidate the progression of voice disorders in extremely preterm children, to inform prognostic predictors and treatment decisions.
authors.affiliation: a University of Western Australia, School of Paediatrics and Child Health , Crawley , Australia.
authors.forename: Victoria
authors.initials: V
authors.lastname: Reynolds
authors.affiliation: a University of Western Australia, School of Paediatrics and Child Health , Crawley , Australia.|b Edith Cowan University, School of Psychology and Speech Pathology , Joondalup , Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Meldrum
authors.affiliation: a University of Western Australia, School of Paediatrics and Child Health , Crawley , Australia.|c King Edward Memorial Hospital, Department of Neonatal Paediatrics , Subiaco , Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Simmer
authors.affiliation: a University of Western Australia, School of Paediatrics and Child Health , Crawley , Australia.|d Princess Margaret Hospital, Department of Paediatric Otorhinolaryngology and Head and Neck Surgery , Subiaco , Australia.|e University of Western Australia, School of Surgery , Crawley , Australia.
authors.forename: Shyan
authors.initials: S
authors.lastname: Vijayasekaran
authors.affiliation: c King Edward Memorial Hospital, Department of Neonatal Paediatrics , Subiaco , Australia.|f State Child Development Centre , West Perth , Australia.
authors.forename: Noel
authors.initials: N
authors.lastname: French
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D000367:Age Factors; D002648:Child; D002657:Child Development; D004185:Disability Evaluation; D055154:Dysphonia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008137:Longitudinal Studies; D010865:Pilot Projects; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D013061:Speech Acoustics; D013068:Speech Production Measurement; D014833:Voice Quality
keywords: Child; dysphonia; intubation; longitudinal; paediatric; premature; preterm; voice