Evaluation of Voice After Open Airway Surgery in Children: A Systematic Review

This review aims to describe the methods used to assess the vocal quality and quality of life of children after airway reconstruction and their limitations.

A systematic review was carried out in 10 databases for articles published between 2000 and 2021 following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses).

Articles were included that described perceptual voice assessment with or without acoustic measures and/or voice quality impact questionnaires. Articles with no description of a specific voice assessment were excluded.

A total of 12 studies were included, yielding 263 patients. The mean age at evaluation was 9 years. Follow-up varied from 5 months to 20 years with most patients being evaluated at least a year after surgery. Methods used to evaluate voice were perceptual, aerodynamic, and acoustic analysis and quality of life questionnaires. CAPE-V (Consensus Auditory Perceptual Evaluation-Voice) was the most used auditory-perceptual instrument (72.7%). Of the acoustic parameters, fundamental frequency and maximum phonation time were the most described (58.3%), and among the quality of life assessment questionnaires, pVHI (Pediatric Voice Handicap Index) was the most used (54.5%).

Multidimensional evaluations tailored to the individual child can be recommended after open airway surgery. CAPE-V scale, fundamental frequency, maximum phonation time, and pVHI are the most frequently used methods; therefore, their use may help broaden communication among authors. In the multitude of methods available, cognitive ability and degree of voice disturbance should be considered since they are the most important limiting factors in this population.