Sphincter pharyngoplasty has wide application in the management of children with VPI, including those with VCFS. The procedure is readily modified to accommodate an individual patient's needs as determined by preoperative VPI evaluation. A modification of the procedure is described to minimize the risk of postoperative airway obstruction and hyponasality, both regarded as airway complications of sphincter pharyngoplasty.
Certain acoustical consequences of endotracheal intubation were examined in 13 male cardiovascular-surgery patients. Each subject recorded three tokens of a sustained vowel 1 day before intubation, 1 day after, upon discharge, and during a follow-up visit. Eight acoustical measures were obtained from the audio-recorded vowels: (a) mean fundamental frequency (Fo), (b) Fo standard deviation, (c) Fo perturbation quotient, (d) mean sound pressure level (SPL), (e) SPL standard deviation, (f) SPL perturbation quotient, (g) spectral flatness of the residue signal, and (h) coefficient of excess. Mean Fo, Fo standard deviation, mean SPL, SPL standard deviation, and coefficient of excess did not differ significantly across recording sessions, although certain predictable trends were apparent. Fo perturbation quotient, SPL perturbation quotient, and spectral flatness of the residue signal varied significantly across sessions, implying that these acoustical measures may be useful in the identification and monitoring of even minor intubation-related laryngeal trauma.
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