[Phonetic results after surgery of laryngotracheal stenoses in children]. / Résultats phoniatriques après chirurgie des sténoses laryngo-trachéales chez l'enfant.

The quality of the results of laryngotracheoplasties is clear evidence of the progress made in the treatment of stenoses involving the larynx and the trachea in children. the surgeon is no longer limited to helping the child breath correctly via the natural airways but can also concentrate on phonatrics since dysphonia is frequent after laryngotracheoplasty. Vocal production of 23 children who had undergone surgery for laryngotracheal stenosis was evaluated subjectively by a panel of listeners and objectively on the basis of the pitch and intensity of the voice, rate of speech and maximal time of phonation. In 11 children over the age of 5 years, assisted assessment of the voice completed the study. In 69.5% of the cases, the voice was subjectively considered to be satisfactory. Voice was considered clear in 52% of the cases. Speech flow was impaired in 39% due to frequent breath taking. Objective parameters revealed that pitch was slightly impaired (256 Hz) with a tendancy to normalize near puberty. The intensity of the voice (77 dB) and mean maximum phonation time (7 s) decreased. The phonotary quotient (270 ml/sec), jitter (1.4%) and leakage of the glottis (2.02 cm3/dB/s) were slightly above the normal range. The spectra of the voices were richly furnished with harmonics up to about 1 000 Hz above which air noises increased. An attempt was made to correlate the analysis of the voice with the characteristics of the stenosis and with the therapeutic methods used. The results would suggest the iatrogenic nature of prolonged canulation and of increasing the size the size of the posterior cricoid.(ABSTRACT TRUNCATED AT 250 WORDS)

[Surgical treatment of subglottic angioma in infants. Technique and indications]. / Le traitement chirurgical des angiomes sous-glottiques du nourrisson. Technique et indications.

Subglottic angiomas, frequently observed in new-borns, can have an unfavourable course due to laryngeal dyspnea. Although the natural course is towards spontaneous involution, different therapeutic approaches depend upon the lesion's sensitivity to corticotherapy. The authors report 24 cases of angioma observed over the last six years at the Hôpital d'Enfants de la Timone in Marseille, France. The relative importance of corticotherapy, intubation, laser and tracheotomy were analyzed and the role of surgical exeresis was analyzed with precision. Four observations were presented in detail. Based on the data in the literature, indications for this therapeutic method would be rather limited, but could offer rapid curative care without complications.