Clinical profile and recovery pattern of dysphonia following inhalation injury: A 10-year review

Introduction: Inhalation injury may be associated with increased risk of dysphonia and laryngotracheal pathology; however, presentation and recovery patterns are not well documented.

Objectives: To examine the prevalence, clinical characteristics, and recovery patterns of dysphonia and laryngeal pathology following inhalation injury.

Methods: A retrospective audit was conducted of all burn patients with diagnosed inhalation injury admitted to two Australian burn units over ten years. Demographic, burn, and critical care data were collected in addition to voice and laryngeal outcomes.

Results: Inhalation injury was confirmed in 167 patients (75 % male, mean age 45 years, mean TBSA 23 %, 90 % head/neck burns, 11 % tracheostomy, mean intubation 7 days, mean ICU length of stay [LOS] 11 days, total LOS 39 days). Laryngeal pathology included oedema/erythema, laryngeal granulation, vocal cord palsy/paresis, and laryngeal contracture. Dysphonia was observed in 55%, increasing to 87 % in those with severe inhalation injury (n = 62). By 6 months, dysphonia had resolved in 98 % of the non-severe and 73 % of the severe cohort. Severe inhalation injury was associated with dysphonia (p < 0.001), poor dysphonia resolution at six months (p < 0.001), and duration of intubation (p = 0.033).

Conclusion(s): Dysphonia occurs in one of every two burn patients with inhalation injury, and a quarter of patients with severe injury will still have persistent dysphonia at six months.