Characterizing Dysphonia After Pediatric Open Airway Reconstruction: Systematic Review and Meta-Analysis

Area of Science:

• Pediatric Otolaryngology
• Speech and Language Pathology
• Surgical Outcomes Research

Background:

• Pediatric laryngotracheal stenosis frequently necessitates open airway reconstruction.
• While successful in establishing ventilation, these surgeries often lead to secondary dysphonia (voice impairment).
• Existing research has explored various vocal outcomes post-reconstruction.

Purpose of the Study:

• To systematically evaluate dysphonia in pediatric patients after open airway reconstruction.
• Focus on analyzing acoustic voice parameters, perceptual voice quality, and voice-related quality of life.
• Synthesize current evidence on vocal function following pediatric airway surgery.

Main Methods:

• Conducted a systematic literature search adhering to PRISMA guidelines across 6 databases.
• Included studies reporting on pediatric patients undergoing open airway reconstruction with vocal outcome data.
• Performed qualitative synthesis and quantitative meta-analyses of common outcomes, assessing risk of bias.

Main Results:

• 21 studies involving 497 pediatric patients were analyzed.
• Laryngotracheoplasty and cricotracheal resection were the most frequent procedures.
• Mean Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) score was 55.6, indicating moderate dysphonia; pediatric Voice Handicap Index (pVHI) mean score was 35.6, suggesting reduced quality of life.

Conclusions:

• Pediatric patients undergoing open airway reconstruction commonly experience dysphonia and reduced voice-related quality of life.
• Significant heterogeneity in study protocols and outcome measures was observed.
• Prioritizing voice preservation during airway reconstruction is essential to mitigate long-term impacts on quality of life.