Surgical management of posterior glottic diastasis in children

Douglas R Sidell; Stephanie Zacharias; Karthik Balakrishnan; Michael J Rutter; Alessandro de Alarcón

doi:10.1177/0003489414543100

Surgical management of posterior glottic diastasis in children

Ann Otol Rhinol Laryngol. 2015 Jan;124(1):72-8. doi: 10.1177/0003489414543100. Epub 2014 Jul 25.

Authors

Douglas R Sidell¹, Stephanie Zacharias², Karthik Balakrishnan¹, Michael J Rutter³, Alessandro de Alarcón⁴

Affiliations

¹ Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
² Division of Speech-Language Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Centers for Pediatric Voice Disorders, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
³ Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Aerodigestive and Esophageal Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
⁴ Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Centers for Pediatric Voice Disorders, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Aerodigestive and Esophageal Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA alessandro.dealarcon@cchmc.org.

PMID: 25063682
DOI: 10.1177/0003489414543100

Abstract

Introduction: The purpose of this study was to report our clinical experience in the surgical management of patients with posterior glottic diastasis (PGD) secondary to prolonged intubation and/or laryngotracheoplasty (LTP) during childhood.

Methods: We reviewed the charts of patients with a history of prolonged intubation and/or LTP who had undergone surgical correction for PGD at our institution between 2010 and 2014. We documented demographic data and pertinent information regarding medical and surgical histories. The Pediatric Voice Handicap Index (pVHI) and/or the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) were used to assess patients both before and after undergoing treatment for voice disorders.

Results: Six patients met our inclusion criteria. With 1 exception, all patients with complete voice data demonstrated improvements in perceptual, patient-reported, and acoustic voice measures. There were no perioperative complications.

Conclusion: Our case series demonstrates that operative intervention can lead to improved voice in carefully selected patients with PGD secondary to prolonged intubation and/or LTP during childhood. Patients exhibited postoperative improvement in loudness and vocal endurance; however, they also exhibited a degree of compromise in voice quality.

Keywords: dysphonia; laryngotracheoplasty; pediatric; posterior glottic diastasis; voice disorders.

Publication types

Case Reports

MeSH terms

Adolescent
Arytenoid Cartilage / surgery*
Child
Cricoid Cartilage / surgery*
Dysphonia / etiology*
Dysphonia / surgery*
Endoscopy*
Female
Glottis*
Humans
Intubation, Intratracheal / adverse effects
Laryngoplasty / adverse effects
Male
Retrospective Studies
Tracheotomy / adverse effects
Treatment Outcome
Young Adult