Jennifer F Ha1, Lynn Driver2, David A Zopf3. 1. Department of Paediatrics Otolaryngology Head & Neck Surgery, University of Michigan Health System, C.S. Mott Children's Hospital, 1540 East Hospital Drive, Ann Arbor, MI 48109, USA; Department of Surgery, University of Western Australia, Stirling Highway, Nedlands, Western Australia 6008, Australia; Department of Paediatrics Otolaryngology Head & Neck Surgery, Princess Margaret Hospital for Children, Roberts Road, Subiaco, Western Australia, Australia; St John of God Hospital (Murdoch), Wexford Medical Center, Suite 17-18, Level 1, 3 Barry Marshall Parade, Murdoch 6150, Western Australia, Australia. Electronic address: drjennha@yahoo.com.au. 2. Department of Speech-Language Pathology, University of Michigan Health Systems, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. 3. Department of Paediatrics Otolaryngology Head & Neck Surgery, University of Michigan Health System, C.S. Mott Children's Hospital, 1540 East Hospital Drive, Ann Arbor, MI 48109, USA.
Abstract
OBJECTIVES: Significant advances in laryngotracheal reconstruction over the last few decades have revolutionised the management of paediatric patients with complex congenital or acquired airway stenosis. The primary aim of laryngotracheal reconstruction has focused primarily on airway and surgery specific outcomes, often at the expense of voice, as well as swallowing function, which are all intricately related. There is currently a paucity of data on swallowing outcome. The goal of this paper is to review and discuss the existing research on the impact of laryngotracheal on swallowing. METHODS: Narrative review. RESULTS: Successful and safe oral feeding in children requires a highly complex and integrated sensorimotor system for proper timing and coordination, beginning with a well-coordinated suck-swallow-breathe sequence in infancy. Factors to consider include the normal laryngeal anatomy, nutrition as a stimulus and the development of feeding skills on swallowing, the underlying aetiology and other risk factors, LTR procedures and their adjuncts. All these impact on the children's growth. Swallow assessments and rehabilitation is therefore an important part of the post-operative care. CONCLUSIONS: As airway reconstructive surgeries have improved in airway and surgery specific outcomes, swallowing function is an important secondary outcome that impacts on the children's and their families' life. Management in a multi-disciplinary manner will optimise the outcome and improve their quality of life.
OBJECTIVES: Significant advances in laryngotracheal reconstruction over the last few decades have revolutionised the management of paediatric patients with complex congenital or acquired airway stenosis. The primary aim of laryngotracheal reconstruction has focused primarily on airway and surgery specific outcomes, often at the expense of voice, as well as swallowing function, which are all intricately related. There is currently a paucity of data on swallowing outcome. The goal of this paper is to review and discuss the existing research on the impact of laryngotracheal on swallowing. METHODS: Narrative review. RESULTS: Successful and safe oral feeding in children requires a highly complex and integrated sensorimotor system for proper timing and coordination, beginning with a well-coordinated suck-swallow-breathe sequence in infancy. Factors to consider include the normal laryngeal anatomy, nutrition as a stimulus and the development of feeding skills on swallowing, the underlying aetiology and other risk factors, LTR procedures and their adjuncts. All these impact on the children's growth. Swallow assessments and rehabilitation is therefore an important part of the post-operative care. CONCLUSIONS: As airway reconstructive surgeries have improved in airway and surgery specific outcomes, swallowing function is an important secondary outcome that impacts on the children's and their families' life. Management in a multi-disciplinary manner will optimise the outcome and improve their quality of life.