Department of Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
Otolaryngol Head Neck Surg. 2011 May;144(5):770-7. doi: 10.1177/0194599810391198.
(1) To assess the long-term impact of thyroid ala cartilage laryngotracheal reconstruction (TAC-LTR) on health-related quality of life (QOL) in infants using 4 validated instruments: Health Utility Index version 3 (HUI3), Pediatric Voice-Related QOL (PVRQOL), Impact on Family Questionnaire, and a visual analog scale and (2) to perform acoustic and perceptual voice assessments to evaluate longterm voice quality outcomes.
Prospective study.
Tertiary academic pediatric hospital.
Eligible children who received TAC-LTR before the age of 24 months between 1995 and 2007.
Interviews with parents and children using 4 validated instruments, voice analyses, and endoscopic evaluation were performed.
Twelve patients (7 male, 5 female, median age 10 years) were enrolled over a 6-month period. The mean age at LTR was 5 months (range, 1-20 months), and the mean study followup period was 9 years (range, 2-14 years). The average speech HUI3, PVRQOL, and Impact on Family scores were 0.83 (95% confidence interval = 0.74, 0.92), 0.93 (interquartile range [IQR] = 0.81, 1.00), and 0.65 (IQR = 0.54, 0.92), respectively. All acoustic scores were either normal or mildly abnormal for the variables jitter, shimmer, noise-to-harmonic ratio, peak amplitude variation, and fundamental frequency. The Consensus Auditory-Perceptual Evaluation of Voice overall severity score was in the normal to mildly abnormal range for 8 of 9 patients.
This is the first study to explore and quantify longterm QOL and voice quality in children following LTR with thyroid ala graft at a very young age. Most patients had very good functional voice outcome as evidenced by the HUI3 and PVRQOL scores. This was corroborated by acoustic and perceptual voice assessments.
（1）使用 4 种经过验证的工具评估甲状腺软骨喉气管重建（TAC-LTR）对婴儿健康相关生活质量（QOL）的长期影响：健康效用指数 3 版（HUI3）、儿科嗓音相关 QOL（PVRQOL）、家庭影响问卷和视觉模拟量表；（2）进行声学和感知嗓音评估，以评估长期嗓音质量结果。
前瞻性研究。
三级学术儿科医院。
1995 年至 2007 年间，24 个月前接受 TAC-LTR 的符合条件的儿童。
对父母和儿童进行 4 种经过验证的工具访谈、嗓音分析和内窥镜评估。
在 6 个月的时间内纳入了 12 名患者（7 名男性，5 名女性，中位年龄 10 岁）。LTR 的平均年龄为 5 个月（范围，1-20 个月），平均研究随访时间为 9 年（范围，2-14 年）。平均言语 HUI3、PVRQOL 和家庭影响评分分别为 0.83（95%置信区间=0.74，0.92）、0.93（四分位距[IQR]=0.81，1.00）和 0.65（IQR=0.54，0.92）。所有声学评分的抖动、颤抖、噪声与谐波比、峰值幅度变化和基频的变量均为正常或轻度异常。9 名患者中有 8 名的共识听觉感知嗓音评估总体严重程度评分处于正常到轻度异常范围内。
这是第一项研究，探讨并量化了非常年幼的儿童在接受甲状腺软骨移植后进行 LTR 的长期 QOL 和嗓音质量。大多数患者的功能嗓音结果非常好，HUI3 和 PVRQOL 评分证明了这一点。这与声学和感知嗓音评估相符。
