Dysphonia in extremely preterm children: A longitudinal observation.
INTRODUCTION
Dysphonia is a potential long-term complication of preterm birth. Childhood voice disorders caused by vocal hyperfunction resolve with pubertal changes to the vocal mechanism in many cases. In extremely preterm children, whose voice quality is affected by supraglottic hyperfunction adapted secondary to underlying structural laryngeal pathology sustained during neonatal intubation, the prognosis is unknown.


METHODS
A pilot study was conducted to assess the incidence and severity of dysphonia in children born at < 25 weeks' gestation. Ten individuals, aged between 9.67 and 17.08 years, presented for repeat assessment in a replication and extension of the original study. The mean period between assessments was 2.85 (SD 0.38) years. The primary outcome measure was the severity score on the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), with the Acoustic Voice Quality Index score as the secondary outcome measure. Scores on the Pediatric Voice Handicap Index were also compared.


RESULTS
Perceptual dysphonia severity scores were significantly lower on repeat assessment, but no differences were observed in objective or quality of life scores. Individual variation was observed: the difference in CAPE-V scores ranged from -36 to + 1. No participant presented with normal voice quality on repeat assessment.


DISCUSSION
Analysis of group data masked individual variability in this series. Mechanisms underlying such individual variation are currently unknown. These data suggest that dysphonia is persistent in extremely preterm children.


CONCLUSION
Further investigation is warranted to elucidate the progression of voice disorders in extremely preterm children, to inform prognostic predictors and treatment decisions.
['Reynolds|Victoria|V|', 'Meldrum|Suzanne|S|', 'Simmer|Karen|K|', 'Vijayasekaran|Shyan|S|', 'French|Noel|N|']
D000293:Adolescent D041923:Adolescent Development D000367:Age Factors D002648:Child D002657:Child Development D004185:Disability Evaluation D055154:Dysphonia D005865:Gestational Age D006801:Humans D062071:Infant, Extremely Premature D007442:Intubation, Intratracheal D008137:Longitudinal Studies D010865:Pilot Projects D011379:Prognosis D012307:Risk Factors D012720:Severity of Illness Index D013061:Speech Acoustics D013068:Speech Production Measurement D014833:Voice Quality
dysphonia preterm longitudinal voice intubation Child paediatric premature