Voice quality in laryngotracheal stenosis: impact of dilation and level of stenosis.

Abstract

OBJECTIVE:

To assess the impact of suspension microlaryngoscopy with balloon dilation on voice-related quality of life (V-RQOL) in laryngotracheal stenosis (LTS).

METHODS:

Retrospective chart review of LTS patients dilated at a tertiary-care academic hospital from 2010 to 2013. Data were obtained and then analyzed. LTS was stratified by (1) subglottic or tracheal stenosis and (2) multilevel stenosis (MLS; glottic and subglottic/tracheal). Pre- and postoperative V-RQOL and grade, roughness, breathiness, asthenia, strain (GRBAS) scores were compared. The number and frequency of balloon dilation procedures over the lifetime were secondary outcome variables.

RESULTS:

Thirty-eight patients were identified: 26 subglottic/tracheal and 12 multilevel. Of these, 71.4% required multiple dilations, with greatest dilations/patient for multilevel stenosis (4.8). V-RQOL improved in the 27 patients with completed pre- and postoperative scores from a mean of 70.4 to 80 (P=.025). Pre/postoperative V-RQOLs for tracheal/subglottic (mean, 82.8/93.8) were significantly higher (P=.0001/.0001) than multilevel stenosis (48/55.3). Voice quality-of-life improvement was significant for the subglottic/tracheal cohort (P=.036) but not for the MLS group. GRBAS was performed pre- and postoperatively in 10 patients with improvement in all domains except breathiness.

CONCLUSION:

Laryngotracheal stenosis is associated with dysphonia. Patients with glottic involvement have significantly worse voice quality of life than those with tracheal/subglottic stenosis. Endoscopic balloon dilation improves V-RQOL in patients with subglottic/tracheal stenosis.

• Authors: Alexander T Hillel, Selmin Karatayli-Ozgursoy, James R Benke, Simon Best, Paulette Pacheco-Lopez, Kristine Teets, Heather Starmer, Lee M Akst
• Journal: The Annals of otology, rhinology, and laryngology (Ann Otol Rhinol Laryngol) Vol. 124 Issue 5 Pg. 413-8 (May 2015) ISSN: 0003-4894 [Print] United States
• PMID: 25519815 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2014.

Topics

• Adult
• Dilatation (methods)
• Female
• Follow-Up Studies
• Humans
• Laryngostenosis (diagnosis, physiopathology, therapy)
• Male
• Middle Aged
• Retrospective Studies
• Severity of Illness Index
• Tracheal Stenosis (diagnosis, physiopathology, therapy)
• Treatment Outcome
• Voice Quality