Outcomes of early infancy laryngeal reconstruction on health- and voice-related quality of life.

OBJECTIVE: We aimed to study the voice, voice-related quality of life (VRQoL) and health-related quality of life (HRQoL) of children who in early infancy underwent a laryngeal split (cotton plasty operation) at the Helsinki University Central Hospital between January 1990 and December 2005. METHODS: A retrospective review identified 17 children, of whom 10 fulfilled the inclusion criteria and participated in the study. Age- and gender-matched volunteers formed a control group. We used generic 16D and 17D questionnaires to assess HRQoL; the Pediatric Voice Outcomes Survey (PVOS) and the pediatric voice-related quality of life (PVRQoL) instrument served to assess VRQoL. The children underwent indirect laryngoscopy and perceptual voice assessment. RESULTS: HRQoL and PVRQoL scores did not differ between subjects and controls. The subjects had lower PVOS scores than did the controls (P<0.01). Perceptual assessment revealed that the subjects' voices were worse off according to the following dimensions: voice is strained, voice is hoarse or husky, and voice is weak/does not resonate (P<0.05). CONCLUSIONS: This study adds to the knowledge on the long-term effects of laryngeal split on children through assessment of their HRQoL and PVRQoL. The study subjects' lower PVOS scores and findings of perceptual assessment point to the effect of cotton plasty on VRQoL and voice.

[Dysphagia--a multidisciplinary challenge]. / Dysfagia--moniammatillinen haaste.

Difficulty in swallowing, i.e. dysphagia should be distinguished from the sensation of a lump in the throat and the pain on swallowing. A careful anamnesis will help in determining the ailment as a problem of oral, pharyngeal or esophageal stage of swallowing. Videofluorography, FEES investigation and transnasal esophagoscopy as well as gastroscopy are helpful for the diagnosis. Cerebral infarction is the most significant cause of oropharyngeal dysphagia. Esophageal causes include reflux disease, tumors and achalasia. Diagnostics, treatment and rehabilitation of dysphagia patients require multidisciplinary collaboration. In addition, surgical therapy may be required.