Department of Surgery, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.
Medical library, CHU Sainte Justine, Montreal, QC, Canada.
J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241266570. doi: 10.1177/19160216241266570.
Pediatric laryngotracheal stenosis often requires open airway reconstruction. While these surgeries establish an airway for adequate ventilation, many patients develop subsequent dysphonia. Numerous studies have reported outcomes related to voice.
This study aims to evaluate dysphonia in pediatric patients following open airway reconstruction, focusing on acoustic parameters, perceptual voice quality, and voice-related quality of life.
A comprehensive search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across 6 databases identified articles involving pediatric patients who underwent open airway reconstruction and reported postoperative vocal acoustic parameters, perceptual voice quality, voice-related quality of life, or vocal mechanics. Articles were assessed for bias risk, and common outcomes were synthesized qualitatively and quantitatively using meta-analyses.
Among 4089 articles, 21 were included, involving 497 pediatric patients. Laryngotracheoplasty was the most common procedure followed by cricotracheal resection. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scale was frequently used to assess voice quality, with a mean score of 55.6 [95% confidence intervals (CIs): 47.9-63.3]. Voice-related quality of life was measured using the pediatric Voice Handicap Index (pVHI) and Pediatric Voice-Related Quality of Life Survey, with mean scores of 35.6 (95% CI: 21.4-49.7) and 83.7 (95% CI: 74.1-93.2), respectively. The fundamental frequency was 210.5 (95% CI: 174.6-246.3). Other common findings included supraglottic phonation, anterior commissure blunting, posterior glottic diastasis, and abnormal vocal cord mobility.
Pediatric patients experiencing dysphonia after open airway reconstruction exhibited moderately decreased voice quality and reduced voice-related quality of life. However, there was inconsistency in study protocols and outcome measures used. Preserving voice quality during airway reconstruction is crucial to avoid negative impacts on quality of life.
小儿喉气管狭窄常需行气道开放重建术。虽然这些手术可以为患者建立足够的通气气道，但许多患者术后会出现声嘶。大量研究报告了与嗓音相关的结果。
本研究旨在评估小儿行气道开放重建术后的嗓音障碍，重点关注声学参数、可感知的嗓音质量和嗓音相关生活质量。
采用系统评价和荟萃分析首选报告项目（PRISMA）指南，对 6 个数据库进行全面检索，以识别纳入小儿行气道开放重建术并报告术后嗓音声学参数、可感知的嗓音质量、嗓音相关生活质量或嗓音力学的研究。评估文章的偏倚风险，并采用荟萃分析定性和定量综合常见结局。
在 4089 篇文章中，有 21 篇符合纳入标准，共纳入 497 例小儿患者。其中喉气管成形术最常见，其次是环状软骨气管切开术。共识性听觉-感知嗓音评估（CAPE-V）量表常用于评估嗓音质量，平均得分为 55.6 分（95%置信区间：47.9-63.3）。小儿嗓音障碍指数（pVHI）和小儿嗓音相关生活质量调查用于测量嗓音相关生活质量，平均得分分别为 35.6 分（95%置信区间：21.4-49.7）和 83.7 分（95%置信区间：74.1-93.2）。基频为 210.5 赫兹（95%置信区间：174.6-246.3）。其他常见发现包括声门上型发声、前联合变钝、后联合分离和声带活动异常。
小儿行气道开放重建术后发生声嘶者的嗓音质量显著下降，嗓音相关生活质量降低。但研究方案和结局测量指标使用不一致。在气道重建过程中，保护嗓音质量对于避免对生活质量产生负面影响至关重要。
