Document Detail


Effect of primary neopharyngeal repair on acoustic characteristics of tracheoesophageal voice after total laryngectomy.
MedLine Citation:
PMID:  18957154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The tracheoesophageal puncture technique of voice restoration enables successful voice rehabilitation after total laryngectomy. Because post-operative voice quality can vary significantly, depending on which type of hypopharyngeal repair is chosen, the aim of this study was to evaluate the effect of such repair on tracheoesophageal puncture voice after total laryngectomy. STUDY DESIGN: Prospective, clinical study. SETTING: Otolaryngology department, Tanta University, Egypt. METHODS: Tracheoesophageal puncture voice was quantitatively and qualitatively evaluated in 40 patients using a Provox 2TM prosthesis after standard total laryngectomy. The patients were divided, according to the type of hypopharyngeal repair, into four groups of 10 cases each, as follows: group one, pharyngoesophageal myotomy; group two, pharyngeal plexus neurectomy; group three, non-muscle vertical repair; and group four, transverse repair. These surgical groups were compared with each other with respect to different voice parameters. RESULTS: Patient profiles were almost equivalent in all surgical groups. The mean values of most of the parameters of quantitative tracheoesophageal puncture voice did not differ significantly, comparing the four surgical groups; however, a slightly significant difference was observed regarding loud intensity in the non-muscle repair group, and soft and loud jitter in the transverse repair group. Mean values for qualitative measures of intelligibility and communicative effectiveness did not show significant difference. However, a slightly significant difference was observed regarding fluency, word correctness, speaking rate and wetness, with higher values for all these parameters except wetness in the myotomy group, and higher values for wetness in the non-muscle repair group. CONCLUSION: The four hypopharyngeal repair types--primary pharyngoesophageal myotomy, pharyngeal plexus neurectomy, non-muscle vertical repair and transverse hypopharyngeal repair--were almost equivalent in prevention of pharyngoesophageal spasm in total laryngectomy patients who had undergone primary tracheoesophageal puncture for voice restoration.
Authors:
O A Albirmawy; A S El-Guindy; M N Elsheikh; M E Saafan; M E Darwish
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Publication Detail:
Type:  Journal Article     Date:  2008-10-28
Journal Detail:
Title:  The Journal of laryngology and otology     Volume:  123     ISSN:  1748-5460     ISO Abbreviation:  J Laryngol Otol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-30     Completed Date:  2009-08-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706896     Medline TA:  J Laryngol Otol     Country:  England    
Other Details:
Languages:  eng     Pagination:  426-33     Citation Subset:  AIM; IM    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Tanta University, Egypt. albirmawy@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Laryngeal Neoplasms / rehabilitation,  surgery*
Laryngectomy / methods,  rehabilitation*
Larynx, Artificial*
Male
Middle Aged
Prospective Studies
Punctures*
Speech Acoustics
Trachea / surgery*
Voice Quality*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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