Current research in voice and swallowing outcomes following pediatric airway reconstruction

Abstract

Pathologic airway conditions in pediatric patients include congenital or acquired subglottic stenosis, glottic stenosis, laryngotracheal stenosis, laryngeal webs or atresia, and tracheal lesions. Acute airway management via tracheotomy is often required with later surgical intervention for reconstruction and expansion of the airway. The effect of the surgical interventions used to expand the airway may impact upon the laryngeal functions of phonation and airway protection during swallowing. Overall, the specific outcomes of airway surgery have focused on airway restoration. Outcomes in regard to voice and swallowing parameters have been largely unexplored, though recent reports have begun to emerge that provide some research data specific to both voice and airway protection/swallowing postoperatively. Research regarding outcomes following laryngotracheal reconstruction over the last year reveals the use of more systematic approaches to collection of voice data and recognition of postoperative dysphagia. There continues to be a dearth of available research regarding longer term swallowing outcomes or treatment of voice disorders in this population. Research findings that contribute to the base of knowledge regarding the effectiveness of surgical methodology for establishment of airway patency with preservation of laryngeal functions of voice and swallowing are beginning to accumulate. Increased evidence regarding types of reconstructive approaches and effect on laryngeal functions will assist surgeons and clinicians in designing specific treatment approaches.