Quality of Life and Voice Outcomes after Thyroid Ala Graft Laryngotracheal Reconstruction in Young Children

Tirado, Yamilet; Chadha, Neil K.; Allegro, Jennifer; Forte, Vito; Campisi, Paolo

doi:10.1177/0194599810391198

Cited by 11 publications

(17 citation statements)

References 23 publications

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“…Patients demonstrated significant improvement in laryngeal resistance, vital capacity, and V-RQOL and DI surveys, whereas no change in acoustic or perceptual evaluation of voice quality was found. These results confirm findings from multiple retrospective studies on voice and dyspnea outcomes after endoscopic airway surgery 6,7 and contribute to the development of a panel of outcome measures in the evaluation and treatment of LTS.…”

Section: Discussionsupporting

confidence: 82%

Evaluation of Dyspnea Outcomes After Endoscopic Airway Surgery for Laryngotracheal Stenosis

Samad

Akst

Karataylı-Özgürsoy

et al. 2016

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Endoscopic airway surgery is a frequently used procedure in the management of laryngotracheal stenosis (LTS); however, no established outcome measures are available to assess treatment response. OBJECTIVE To assess acoustics and aerodynamic measures and voice- and dyspnea-related quality of life (QOL) in adult patients with LTS who undergo endoscopic airway surgery. DESIGN, SETTING, AND PARTICIPANTS This case series compared preoperative measures and postoperative outcomes among adult patients who underwent endoscopic airway surgery for LTS from September 1, 2013, to September 30, 2015, at the tertiary care Johns Hopkins Voice Center. Patients were excluded if they did not undergo balloon dilation or if they had multilevel or glottic stenosis. The Phonatory Aerodynamic System was used to quantify laryngotracheal aerodynamic changes after surgery. Final follow-up was completed 2 to 6 weeks after surgery. MAIN OUTCOMES AND MEASURES The voice-related QOL instrument (V-RQOL), Dyspnea Index, and Clinical Chronic Obstructive Pulmonary Disease Questionnaire were completed before and after endoscopic surgery. Consensus auditory perceptual evaluation of voice, acoustic measurements, and aerodynamic outcomes were also assessed. RESULTS Fourteen patients (1 man and 13 women; mean [SD] age, 45.4 [4.3] years) were enrolled. The mean postoperative V-RQOL scores (n = 14) increased from 74.3 to 85.5 (mean of difference, 11.3; 95%CI, 2.2 to 20.3). The mean postoperative Dyspnea Index (n = 14) decreased from 26.9 to 6.6 (mean of difference, −20.3; 95%CI, −27.9 to −12.7); the mean postoperative Clinical Chronic Obstructive Pulmonary Disease Questionnaire scores (n = 9) decreased from 3.2 to 1.0 (mean of difference, −2.2; 95% CI, −3.4 to −0.9). Postoperative mean vital capacity (n = 14) increased from 2.5 to 3.1 L (mean of difference, 0.6 L; 95%CI, 0.3–1.0 L), whereas mean laryngeal resistance (n = 14) decreased from 73.9 to 46.4 cm H2O/L/s (mean of difference, −27.5 cm H2O/L/s; 95%CI, −44.8 to −10.3 cm H2O/L/s) postoperatively. CONCLUSIONS AND RELEVANCE Patients demonstrate statistically clinically significant improvement in dyspnea-related QOL, whereas a few patients showed a clinically significant improvement in V-RQOL. Dyspnea-related QOL outcomes should be added to airway surgeons’ regular assessment of patients with LTS to measure treatment response and inform the decision to perform a second operation, whereas V-RQOL outcomes need additional prospective study with a larger sample size. The Phonatory Aerodynamic System is not an optimal method to quantify changes in laryngotracheal aerodynamics after intervention in LTS.

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Section: Discussionsupporting

confidence: 82%

Evaluation of Dyspnea Outcomes After Endoscopic Airway Surgery for Laryngotracheal Stenosis

Samad

Akst

Karataylı-Özgürsoy

et al. 2016

JAMA Otolaryngol Head Neck Surg

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“…Therefore, they are generally not obtained and not required. In adults, however, a functional assessment should routinely be obtained [62][63][64][65].…”

Section: Functional Assessment Of Respiration and Voicementioning

confidence: 99%

Preoperative assessment and classification of benign laryngotracheal stenosis: a consensus paper of the European Laryngological Society

Monnier

Dikkers

Eckel

et al. 2015

Eur Arch Otorhinolaryngol

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Adult and pediatric laryngotracheal stenoses (LTS) comprise a wide array of various conditions that require precise preoperative assessment and classification to improve comparison of different therapeutic modalities in a matched series of patients. This consensus paper of the European Laryngological Society proposes a five-step endoscopic airway assessment and a standardized reporting system to better differentiate fresh, incipient from mature, cicatricial LTSs, simple one-level from complex multilevel LTSs and finally ''healthy'' from ''severely morbid'' patients. The proposed scoring system, which integrates all of these parameters, may be used to help define different groups of LTS patients, choose the best treatment modality for each individual patient and assess distinct post-treatment outcomes accordingly.

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“…Although successful surgical correction of airway stenosis is a realistic goal for an experienced surgeon, the evolution and future of airway reconstruction remain the development of innovative techniques for voice preservation while achieving airway patency. 57,58 Subglottic Hemangioma SGH is a rare vascular tumor of the larynx, which presents after 4 to 6 weeks of life and undergoes 3 to 6 months of rapid proliferation, after which a slow involution phase follows, with complete resolution in most patients by 5 to 7 years of age. Patients present with stridor that worsens with crying because of vascular engorgement, and edema from increased air flow turbulence across the subglottic mucosa.…”

Section: Subglottic Stenosismentioning

confidence: 99%

Pediatric Stridor

Ida

Thompson

2014

Otolaryngologic Clinics of North America

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Pediatric stridor is an important symptom of upper airway obstruction, and must be recognized early by evaluating physicians. Proper evaluation and management, both acutely and chronically, can provide improved outcomes and better quality of life for patients. This article discusses the physiology of stridor and its intimate relation to airway anatomy, the work-up of the stridorous child, and recent advances in treatment, and provides illustrative examples of common lesions.

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Quality of Life and Voice Outcomes after Thyroid Ala Graft Laryngotracheal Reconstruction in Young Children

Cited by 11 publications

References 23 publications

Evaluation of Dyspnea Outcomes After Endoscopic Airway Surgery for Laryngotracheal Stenosis

Evaluation of Dyspnea Outcomes After Endoscopic Airway Surgery for Laryngotracheal Stenosis

Preoperative assessment and classification of benign laryngotracheal stenosis: a consensus paper of the European Laryngological Society

Pediatric Stridor

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