耳鼻科杂志

Phonatory Activity after Supracricoid Partial Laryngectomy

Cesari U, Motta S, Rossi G and Apisa P

Phonatory Activity after Supracricoid Partial Laryngectomy

Aim of this study is to evaluate the phonatory activity following reconstructive laryngectomy and the real recovery possibilities offered by rehabilitation techniques. We examined 24 patients treated with partial laryngectomy (14 males and 10 females, between the ages of 50 and 64 years, mean age of 56) with deglutition and voice difficulties after surgery.

14 patients had undergone cricohyoidoepiglottopexy (CHEP), with preservation of a single arytenoids. 10 subjects had undergone cricohyoidopexy (CHP), with preservation of a single arytenoid.

Before and after speech therapy, each subject underwent laryngostroboscopy with flexible endoscope, spectography and aerodynamic evaluations.

Each subject was asked to complete the questionnaire of voice perceptual self-evaluation: Voice Handicap Index (VHI). Our experience shows how substitution voice in supracricoid laryngectomy is characterized by remarkable noise quality (in the CHEP the phonatory duration was 8.8 sec, subglottic pressure 14.21 cm H₂O, phonatory flow 0.336 l/sec instead in the CHP the phonatory duration was 8.5 sec, the subglottic pressure 6.46 cm H₂O and the phonatory flow 0.289 l/sec). This causes a clearly difficult voice recovery, especially from a psychological point of view.

In addition to evaluate verbal intelligibility, the speech therapist has to consider that it can be difficult for the patient to accept his/her new vocal timbre.