Department of Otolarygnology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A.
Pediatric Otolaryngology, Texas Children's Hospital, Houston, Texas, U.S.A.
Laryngoscope. 2024 Dec;134(12):5006-5009. doi: 10.1002/lary.31667. Epub 2024 Aug 7.
Pediatric nonselective laryngeal reinnervation (NSLR) has gained popularity in recent years; however, long-term outcomes have not been reported.
Patients greater than 1 year post reinnervation were recruited. Families were asked to report Pediatric Voice-Related Quality of Life (PVRQOL) and provide an audio recording of connected speech. PVRQOL and voice measures were compared with preoperative and early postoperative outcomes (<12 months) using analysis of variance (ANOVA) for repeated measures and post hoc tests for linear trend.
Sixty-six patient families were contacted. Twelve patients responded with PVRQOL; six (50%) were female. Median age at surgery was 6.4 (range 1.9-15) and at follow-up 13.5 (range 10-18), with a median of 6.8 years (range 3-9.1) since surgery at follow-up. Mean preoperative PVRQOL was 68.1 (95% CI 52.3-84.0), early postoperative 86.5 (73.2-99.7), and long-term 90 (82.7-97.3). ANOVA showed no significant difference between values (p = 0.1228), but post hoc testing showed improving outcomes over time (p-for-trend 0.0304). PVRQOL was stable between early postoperative and long-term values (p = 0.3399). Four voice samples were adequate for analysis. Mean preoperative cepstral peak prominence (CPP) was 5.2 (95% CI 3.4-7.0), early postoperative 8.5 (5.5-11.5), and long-term 6.8 (2.77-10.89, p = 0.3340, p-for-trend 0.2988) Low-to-high spectral ratio was 22.3 preoperatively (14.0-30.5), 23.0 early postoperative (17.4-28.7), and 28.8 long-term (17.4-40.2, p = 0.1174, p-for-trend 0.0364). Cepstral spectral index of dysphonia (CSID) was 83.0 preoperatively (44.1-121.8), 39.4 early postoperative (20.4-58.3), and 45.53 long-term (-0.05-91.1, p = 0.4457, p-for-trend 0.1464).
Years after NSLR, PVRQOL, low-to-high spectral ratio, and CSID show no evidence of degradation over time.
4 Laryngoscope, 134:5006-5009, 2024.
小儿非选择性喉返神经再支配（NSLR）近年来越来越受欢迎，但尚未报道其长期结果。
招募术后大于 1 年的患者。要求家属报告小儿嗓音相关生活质量（PVRQOL），并提供连接语音的录音。使用重复测量方差分析（ANOVA）和事后检验线性趋势，将 PVRQOL 和嗓音测量结果与术前和早期术后（<12 个月）结果进行比较。
共联系了 66 名患者家属。12 名患者对 PVRQOL 做出了回应，其中 6 名（50%）为女性。手术时的中位年龄为 6.4 岁（范围 1.9-15 岁），随访时为 13.5 岁（范围 10-18 岁），随访时手术中位时间为 6.8 年（范围 3-9.1 年）。术前 PVRQOL 的平均得分为 68.1（95%CI 52.3-84.0），早期术后为 86.5（73.2-99.7），长期为 90（82.7-97.3）。方差分析显示数值之间无显著差异（p=0.1228），但事后检验显示随时间推移结果有所改善（p 趋势=0.0304）。早期术后和长期 PVRQOL 值之间稳定（p=0.3399）。有 4 个语音样本可供分析。术前平均倒频谱峰突出度（CPP）为 5.2（95%CI 3.4-7.0），早期术后为 8.5（5.5-11.5），长期为 6.8（2.77-10.89，p=0.3340，p 趋势=0.2988）。低-高光谱比术前为 22.3（14.0-30.5），早期术后为 23.0（17.4-28.7），长期为 28.8（17.4-40.2，p=0.1174，p 趋势=0.0364）。嗓音障碍的倒频谱谱指数（CSID）术前为 83.0（44.1-121.8），早期术后为 39.4（20.4-58.3），长期为 45.53（-0.05-91.1，p=0.4457，p 趋势=0.1464）。
在 NSLR 后数年，PVRQOL、低-高光谱比和 CSID 均未随时间出现退化迹象。
4 级喉镜，134：5006-5009，2024。
