Abstract：
OBJECTIVE: Airway reconstruction for laryngo tracheal stenosis (LTS) improves dyspnoea. There is little evidence relating to impact upon voice and swallowing. We explored voice and swallowing outcomes in adults with LTS before and after reconstructive surgery.
METHODS: Outcome measures were collected pre-reconstructive surgery, two-weeks post-surgery and up to 4-6 months post-surgery.
METHODS: Tertiary referral centre.
METHODS: With ethical approval, twenty consecutive adult (≥18 years) LTS patients undergoing airway reconstruction were prospectively recruited.
METHODS: These included physiological values (maximum phonation time (MPT) and fundamental frequency; penetration aspiration score, residue score), clinician-reported (GRBAS, functional oral intake score, 100ml Water Swallow Test) and patient-reported outcomes (Voice Handicap Index-10, Reflux Symptoms Index, Eating Assessment Tool, Dysphagia Handicap Index).
RESULTS: The observational study identified patient-reported and clinician-reported voice and swallow difficulties pre- and post-surgery; median and interquartile range are reported at each time point: Voice Handicap Index-10 23 (8-31); 20.5 (9-33.5), 24.5 (12.5-29); Dysphagia Handicap Index 9 (0-37); 13 (7-44); 15 (4-34); GRBAS grade 1(1-2); 2 (1-2.5); 2(1-2); 100ml Water Swallow Test volume score 16.7 (11.1-20); 14.3 (12.5-16.7); 16.7 (14.3-20.0); 100ml Water Swallow Test capacity score 16.3 ± 9.0; 11.0 ± 4.1; 12.5 ± 2.6.
CONCLUSIONS: We present the first prospective data on voice and swallowing outcomes in adults with LTS before and after reconstructive surgery. The variability of the outcomes was higher than expected but importantly, for many the voice and swallow outcomes were not within normal limits before surgery. The clinical value of the study demonstrates the need for individual assessment and management of LTS patients\' voice and swallowing.
METHODS: Outcome measures were collected pre-reconstructive surgery, two-weeks post-surgery and up to 4-6 months post-surgery.
METHODS: Tertiary referral centre.
METHODS: With ethical approval, twenty consecutive adult (≥18 years) LTS patients undergoing airway reconstruction were prospectively recruited.
METHODS: These included physiological values (maximum phonation time (MPT) and fundamental frequency; penetration aspiration score, residue score), clinician-reported (GRBAS, functional oral intake score, 100ml Water Swallow Test) and patient-reported outcomes (Voice Handicap Index-10, Reflux Symptoms Index, Eating Assessment Tool, Dysphagia Handicap Index).
RESULTS: The observational study identified patient-reported and clinician-reported voice and swallow difficulties pre- and post-surgery; median and interquartile range are reported at each time point: Voice Handicap Index-10 23 (8-31); 20.5 (9-33.5), 24.5 (12.5-29); Dysphagia Handicap Index 9 (0-37); 13 (7-44); 15 (4-34); GRBAS grade 1(1-2); 2 (1-2.5); 2(1-2); 100ml Water Swallow Test volume score 16.7 (11.1-20); 14.3 (12.5-16.7); 16.7 (14.3-20.0); 100ml Water Swallow Test capacity score 16.3 ± 9.0; 11.0 ± 4.1; 12.5 ± 2.6.
CONCLUSIONS: We present the first prospective data on voice and swallowing outcomes in adults with LTS before and after reconstructive surgery. The variability of the outcomes was higher than expected but importantly, for many the voice and swallow outcomes were not within normal limits before surgery. The clinical value of the study demonstrates the need for individual assessment and management of LTS patients\' voice and swallowing.
摘要：
目的：喉气管狭窄（LTS）的气道重建可改善呼吸困难。几乎没有证据表明对声音和吞咽的影响。我们探讨了重建手术前后成人LTS患者的语音和吞咽结果。
方法：结果测量是收集重建前手术，手术后两周和手术后4-6个月。
方法：三级转诊中心。
方法：经伦理批准，前瞻性招募了20例接受气道重建的连续成人(≥18岁)LTS患者.
方法：这些包括生理值（最大发声时间（MPT）和基频；穿透抽吸评分，残留物评分)，临床医生报告(GRBAS，功能性口腔摄入评分，100毫升水吞咽测试）和患者报告的结果（语音障碍指数-10，反流症状指数，饮食评估工具，吞咽困难指数)。
结果：观察性研究确定了手术前后患者报告和临床医生报告的语音和吞咽困难；每个时间点报告的中位数和四分位数范围：语音障碍指数-1023（8-31）；20.5（9-33.5），24.5（12.5-29）;吞咽困难指数9（0-37）;13（7-44）;15（4-34）;GRBAS1级（1-2）;2（1-2.5）;2（1-2）;100ml吞下水测试体积得分16.7（11.1-20）;14.3（12.5-16.7）;16.7（14.3-20.0）;水±1003分
结论：我们提供了关于重建手术前后成人LTS患者语音和吞咽结局的第一个前瞻性数据。结果的可变性高于预期，但重要的是，对于许多患者,手术前语音和吞咽结局不在正常范围内.该研究的临床价值表明需要对LTS患者的声音和吞咽进行个人评估和管理。
方法：结果测量是收集重建前手术，手术后两周和手术后4-6个月。
方法：三级转诊中心。
方法：经伦理批准，前瞻性招募了20例接受气道重建的连续成人(≥18岁)LTS患者.
方法：这些包括生理值（最大发声时间（MPT）和基频；穿透抽吸评分，残留物评分)，临床医生报告(GRBAS，功能性口腔摄入评分，100毫升水吞咽测试）和患者报告的结果（语音障碍指数-10，反流症状指数，饮食评估工具，吞咽困难指数)。
结果：观察性研究确定了手术前后患者报告和临床医生报告的语音和吞咽困难；每个时间点报告的中位数和四分位数范围：语音障碍指数-1023（8-31）；20.5（9-33.5），24.5（12.5-29）;吞咽困难指数9（0-37）;13（7-44）;15（4-34）;GRBAS1级（1-2）;2（1-2.5）;2（1-2）;100ml吞下水测试体积得分16.7（11.1-20）;14.3（12.5-16.7）;16.7（14.3-20.0）;水±1003分
结论：我们提供了关于重建手术前后成人LTS患者语音和吞咽结局的第一个前瞻性数据。结果的可变性高于预期，但重要的是，对于许多患者,手术前语音和吞咽结局不在正常范围内.该研究的临床价值表明需要对LTS患者的声音和吞咽进行个人评估和管理。
