Wertz Aileen, Ha Jennifer F, Driver Lynn E, Zopf David A
Department of Otolaryngology - Head & Neck Surgery, University of Michigan Health System, C.S. Mott Children's Hospital, 1540 East Hospital Drive, Ann Arbor, MI 48109, United States.
School of Surgery, University of Western Australia, Stirling Highway, Nedlands, 6008 Western Australia, Australia; Department of Paediatric Otorhinolaryngology - Head & Neck Surgery, Princess Margaret Hospital for Children, Roberts Road, Subiaco, 6009 Western Australia, Australia.
Int J Pediatr Otorhinolaryngol. 2018 Jan;104:216-219. doi: 10.1016/j.ijporl.2017.11.017. Epub 2017 Nov 23.
To describe changes in diet and swallow function in patients with a laryngeal cleft after surgical repair of the laryngeal cleft.
Retrospective case series performed using chart review. Primary outcomes were diet and swallow function before and after laryngeal cleft repair. Clinical evaluation and video fluoroscopic swallow studies (VFSS) were used to assess pre- and post intervention swallowing.
16 pediatric patients were included in this study. Preoperatively, 14 (88%) patients had diet restrictions. Postoperatively, 12 (75%) patients tolerated a regular diet without limitation. 4 (25%) patients had no reduction in diet restrictions over the course of this study. For the 10 patients who transitioned to a regular diet postoperatively, a median of 300 days (range: 26 days - 3 years) passed to document achieving a regular diet. This was corroborated by an increase in normal oral and pharyngeal phase swallow function on VFSS postoperatively when compared with preoperative VFSS results.
Dysphagia improves in most patients after laryngeal cleft repair. The range in time to a normal diet was wide. This may facilitate improved preoperative counseling and preparation of families' expectations.
描述喉裂手术修复后患者的饮食和吞咽功能变化。
采用病历回顾进行回顾性病例系列研究。主要结局指标为喉裂修复前后的饮食和吞咽功能。采用临床评估和视频荧光吞咽造影检查（VFSS）评估干预前后的吞咽情况。
本研究纳入了16例儿科患者。术前，14例（88%）患者有饮食限制。术后，12例（75%）患者能耐受常规饮食且无限制。4例（25%）患者在本研究过程中饮食限制未减轻。对于术后转为常规饮食的10例患者，记录到实现常规饮食的中位时间为300天（范围：26天至3年）。与术前VFSS结果相比，术后VFSS显示正常口腔和咽期吞咽功能增加，证实了这一点。
大多数患者喉裂修复后吞咽困难得到改善。恢复正常饮食的时间范围较宽。这可能有助于改善术前咨询并使家庭期望更合理。
