Long-term voice outcome following partial cricotracheal resection in children for severe subglottic stenosis.

Détails

ID Serval
serval:BIB_8AF0843B4ACE
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Long-term voice outcome following partial cricotracheal resection in children for severe subglottic stenosis.
Périodique
International Journal of Pediatric Otorhinolaryngology
Auteur(s)
George Mercy, Monnier Philippe
ISSN
1872-8464[electronic], 0165-5876[linking]
Statut éditorial
Publié
Date de publication
2010
Volume
74
Numéro
2
Pages
154-160
Langue
anglais
Résumé
OBJECTIVE: To correlate the postoperative voice outcome to preoperative glottic involvement, following partial cricotracheal resection (PCTR) in children. The glottic involvement was analysed based on the extent of subglottic stenosis (SGS) in the endoscopic image and functional dynamic assessment using flexible endoscopy. METHODS: We conducted an interobserver study in which two ENT surgeons, blinded to one another's interpretation, independently rated the extent of SGS based on the endoscopic image along with the dynamic functional airway assessment, of 108 children who underwent PCTR for grade III or IV stenosis. Based on the observation, the glottic involvement was rated into 4 categories: Evaluation of the voice was based on a parent/patient proxy questionnaire sent in 2008 to assess the current functional status of the patient's voice. RESULTS: Among the 77 patients available for long-term outcome with a minimum 1-year follow-up, 31 patients had isolated SGS free from vocal cords (group A) and 30 had SGS reaching the under surface of vocal cords with partial or no impairment of abduction of vocal cords (group B). Twelve patients belonged to group C with posterior glottic stenosis and/or vocal cord fusion (without cricoarytenoid ankylosis) and 4 patients had transglottic stenosis and or/bilateral cricoarytenoid ankylosis (group D). The long-term voice outcome following PCTR as perceived by the parent or patient was normal in 18% (14 of 77 patients) and the remaining 63 patients demonstrated mild to severe dysphonia. Patients belonging to group A and B exhibited either normal voice or mild dysphonia. Patients in group C demonstrated dysphonia, which was moderate in severity in the majority (83%). All patients in group D with transglottic stenosis and/or CAA showed severe dysphonia. CONCLUSION: Children with associated glottic involvement are at high risk for poor voice outcome following PCTR. The severity of dysphonia was found to be proportional to the preoperative glottic involvement. Preoperative rating of the extent of glottic involvement based on endoscopic image and dynamic assessment was found to be useful in prognosticating the voice outcome.
Mots-clé
Partial Cricotracheal Resection, Voice, Severe Subglottic Stenosis, Laryngotracheal Reconstruction, Quality, Reliability, Ratings, Scale
Pubmed
Web of science
Création de la notice
09/03/2010 14:31
Dernière modification de la notice
03/03/2018 19:10
Données d'usage