title: Voice and swallowing outcomes for adults undergoing reconstructive surgery for laryngotracheal stenosis.
abstract: OBJECTIVE
  Adult laryngotracheal stenosis is a rare, multifactorial condition which carries a significant physical and psychosocial burden. Surgical approaches have developed in recent years, however, voice and swallowing function can be affected prior to treatment, in the immediate postoperative phase, and as an ongoing consequence of the condition and surgical intervention. In this study we discuss: the nature of the problem; surgical interventions to address airway disorders; optimal patterns of care to maximize voice and swallowing outcomes.
  
  
  RESULTS
  Studies in this field are limited and focused on surgical outcomes and airway status with voice and swallowing a secondary consideration. Retrospective studies of swallowing have focused on factors such as the duration of dysphagia symptoms following airway surgery and made comparisons between type of surgery, use of stent, and length of swallowing problems. The literature suggests that patients are likely to return to their preoperative diet. There has been a focus on voice outcomes following cricotracheal resection which results in a postoperative decrease in the fundamental frequency. However, study comparisons are limited by the use of inconsistent outcome measures (for both voice and swallowing) which are often not validated, with heterogeneous groups and varying surgical techniques.
  
  
  CONCLUSIONS
  The limited literature suggests that swallowing function is more likely to recover to presurgical status than voice function. Further prospective studies incorporating consistent instrumental, clinician, and patient-reported outcome measurement are required to understand the nature and extent of dysphagia and dysphonia resulting from this condition and its treatment.
authors.affiliation: aSpeech and Language Therapy Department, Imperial College Healthcare NHS Trust bNational Centre for Airway Reconstruction, Department of Ear, Nose and Throat Surgery, Imperial College Healthcare NHS Trust cDivision of Surgery, Department of Surgery and Cancer, Imperial College London.
authors.forename: Gemma M
authors.initials: GM
authors.lastname: Clunie
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Kinshuck
authors.forename: Gurpreet S
authors.initials: GS
authors.lastname: Sandhu
authors.forename: Justin W G
authors.initials: JWG
authors.lastname: Roe
mesh_terms: D000328:Adult; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000209:etiology*; D006801:Humans; D007829:Laryngostenosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014831:Voice / Q000502:physiology*