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Managing dysphonia in paediatric patients with complex airway conditions

Published online by Cambridge University Press:  17 June 2015

S Ojha ,
J Setlur ,
G Bunting  and
C J Hartnick
S Ojha*
Affiliation:
Royal National Throat, Nose and Ear Hospital, London, UK
J Setlur
Affiliation:
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
G Bunting
Affiliation:
Department of Speech-Language and Swallowing Disorders, Massachusetts General Hospital, Boston, Massachusetts, USA
C J Hartnick
Affiliation:
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
*
Address for correspondence: Miss Shilpa Ojha, 194 Bromyard Avenue, Acton, London W3 7FN, UK E-mail: [email protected]
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Abstract

Objective:

To suggest a phonosurgical management strategy that can be used for children who have previously undergone laryngotracheal reconstruction.

Methods:

This cases series describes three children who presented with complex, multi-level airway stenosis and marked dysphonia. Phonosurgical intervention involved endoscopic and open approaches, and was combined with voice therapy. A phonosurgical reconstruction management algorithm is suggested for evaluating and treating these complex conditions.

Results:

Pre-operative assessment is critical, and should involve voice analysis and glottal anatomy assessment using office laryngoscopy and stroboscopy. The risks must be weighed up against the benefit of vocal improvement. Surgical intervention should involve combined endoscopic and open approaches.

Conclusion:

Voice restoration after paediatric airway reconstruction is a complex challenge. Surgical intervention should be conducted in a step-by-step manner to reduce the risk of worsening dysphonia and airway compromise. The risks and benefits must be carefully explored and discussed.

Keywords

DysphoniaChildVoice DisordersAlgorithmLaryngoscopy
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 8 , August 2015 , pp. 820 - 824
Copyright
Copyright © JLO (1984) Limited 2015 

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