Voice quality following laryngotracheal reconstruction

Management of oral feeding in children undergoing airway reconstruction

“…[2][3][4][5] Recently, several studies have begun to characterize voice outcome following laryngotracheal reconstruction (LTR). [6][7][8][9] Many children who undergo LTR present with dysphagia preoperatively and some may develop it postoperatively. 10 We routinely screen our patients for swallowing difficulties before performing LTR.…”

Vibratory source, vocal quality and fundamental frequency following pediatric laryngotracheal reconstruction

“…Several structural features, including anterior commissure blunting, vocal fold vertical level misapproximation or asymmetry, and posterior glottic gaps have been identified as negatively impacting phonation [15,16]. Previous investigators have noted that some children post-LTR phonate with supraglottic structures [5,7,10,15,16].…”

“…Although the data describing voice following LTR are limited, investigators have consistently noted that many children exhibit dysphonia following successful airway reconstruction [5,7,15,16]. Descriptions of post-surgical laryngeal structure and mobility related to phonation have been included in several studies.…”

“…Vocal quality following LTR has been examined using perceptual characterization [5,7,9,10,15,16] and acoustic analysis [5,9]. There are strengths and limitations to both methods in terms of how precisely and reliably vocal quality may be described.…”

“…Next, the stability of the raters' internal standards over time must derive from experience and skill and be objectively measured using intra-rater reliability tasks if we are to compare one subject's perceptual ranking with another, or a subject's first ranking with a subsequent ranking [17,20,21]. Although several studies describing vocal quality following LTR have addressed the issue of inter-rater reliability on a subjective assessment tool [7,10,15,16], none have reported detail about the background and years of experience of the raters, or the number of raters used. The methods used for rating (i.e., the use of a likert scale versus a visual analog scale, instructions provided to the raters) were also not consistently provided.…”