Long‐Term Outcomes of Pediatric Laryngeal Reinnervation

Abstract

OBJECTIVEPediatric nonselective laryngeal reinnervation (NSLR) has gained popularity in recent years; however, long‐term outcomes have not been reported.METHODSPatients greater than 1 year post reinnervation were recruited. Families were asked to report Pediatric Voice‐Related Quality of Life (PVRQOL) and provide an audio recording of connected speech. PVRQOL and voice measures were compared with preoperative and early postoperative outcomes (<12 months) using analysis of variance (ANOVA) for repeated measures and post hoc tests for linear trend.RESULTSSixty‐six patient families were contacted. Twelve patients responded with PVRQOL; six (50%) were female. Median age at surgery was 6.4 (range 1.9–15) and at follow‐up 13.5 (range 10–18), with a median of 6.8 years (range 3–9.1) since surgery at follow‐up. Mean preoperative PVRQOL was 68.1 (95% CI 52.3–84.0), early postoperative 86.5 (73.2–99.7), and long‐term 90 (82.7–97.3). ANOVA showed no significant difference between values (p = 0.1228), but post hoc testing showed improving outcomes over time (p‐for‐trend 0.0304). PVRQOL was stable between early postoperative and long‐term values (p = 0.3399).Four voice samples were adequate for analysis. Mean preoperative cepstral peak prominence (CPP) was 5.2 (95% CI 3.4–7.0), early postoperative 8.5 (5.5–11.5), and long‐term 6.8 (2.77–10.89, p = 0.3340, p‐for‐trend 0.2988) Low‐to‐high spectral ratio was 22.3 preoperatively (14.0–30.5), 23.0 early postoperative (17.4–28.7), and 28.8 long‐term (17.4–40.2, p = 0.1174, p‐for‐trend 0.0364). Cepstral spectral index of dysphonia (CSID) was 83.0 preoperatively (44.1–121.8), 39.4 early postoperative (20.4–58.3), and 45.53 long‐term (−0.05–91.1, p = 0.4457, p‐for‐trend 0.1464).CONCLUSIONSYears after NSLR, PVRQOL, low‐to‐high spectral ratio, and CSID show no evidence of degradation over time.Level of Evidence4 Laryngoscope, 2024