■气道重建后发声障碍(PARD)很常见,对患者的生活质量有显着影响。声带注射增强(VFIA)是一种可用于改善某些患者声门功能不全的治疗方法。这项研究的目的是描述VFIA用于PARD的用途和结果。
■2007年1月至2018年7月在三级儿科护理中心进行的回顾性图表回顾。连续接受VFIA的PARD患者,VFIA后3个月内进行了术前语音评估和随访评估(脂肪,羧甲基纤维素凝胶,透明质酸)。
■34名患者(20名女性)接受了VFIA。注射时的平均年龄为13.6岁(SD6.1)。20例患者(58.8%)有早产史,平均进行1.8次开放气道手术。注射后,29/34例患者(85.3%)注意到主观声音改善。基线一致听觉-感知语音评估(CAPE-V)总体严重程度评分平均下降5.7分(SD=19.6),P=.12。总儿科语音障碍指数(pVHI)提高了6.0(SD=19.5)分,从57.4(SD=20.0)到51.4(SD=17.2),P=.09。功能pVHI子评分显示出显着改善,下降3.4(SD=7.3)点,P=.02。所有程序均为过夜观察,无并发症发生。
■PARD患者代表患者的复杂子集。VFIA是一种直接的干预措施,可以改善语音感知。尽管客观测量最小,但许多患者报告主观改善。需要进一步的工作来阐明注射在PARD管理中的作用。
UNASSIGNED: Post airway reconstruction dysphonia (PARD) is common and has a significant effect on the quality of life of patients. Vocal fold injection augmentation (VFIA) is one treatment that can be used to improve glottic insufficiency in some patients. The goal of this study was to characterize the use and outcomes of VFIA for PARD.
UNASSIGNED: Retrospective chart review from January 2007 to July 2018 at a tertiary pediatric care center. Consecutive patients with PARD who underwent VFIA, who had a preoperative voice evaluation and a follow-up evaluation within 3 months after VFIA (fat, carboxymethylcellulose gel, hyaluronic acid).
UNASSIGNED: Thirty-four patients (20 female) underwent VFIA. The mean age at the time of the injection was 13.6 years (SD 6.1). Twenty patients (58.8%) had a history of prematurity and a mean of 1.8 open airway surgeries. After injection, 29/34 patients (85.3%) noted a subjective voice improvement. The baseline Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) overall severity score decreased by a mean of 5.7 (SD = 19.6) points, P = .12. Total pediatric Voice Handicap Index (pVHI) improved by 6.0 (SD = 19.5) points, from 57.4 (SD = 20.0) to 51.4 (SD = 17.2), P = .09. Functional pVHI subscore demonstrated a significant improvement, with a decrease of 3.4 (SD = 7.3) points, P = .02. All procedures were performed as an overnight observation and no complication occurred.
UNASSIGNED: Patients with PARD represent a complex subset of patients. VFIA is a straightforward intervention that may improve voice perception. Many patients reported subjective improvement despite minimal objective measurement. Further work is warranted to elucidate the role of injection in management of PARD.