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.

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