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Effect of primary, cross-over, zigzag neopharyngoplasty on acoustic characteristics of alaryngeal, tracheoesophageal voice

Published online by Cambridge University Press:  07 June 2011

O A Albirmawy
O A Albirmawy*
Affiliation:
Otolaryngology Department, Tanta University Hospital, Egypt
*
Address for correspondence: Dr Osama Amin Albirmawy, 88 Reyad St, Tanta 31211, Gharbeya, Egypt E-mail: albirmawy@hotmail.com
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Abstract

Objective:

To evaluate the effect of primary, cross-over, zigzag neopharyngeal construction on tracheoesophageal voice, compared with pharyngoesophageal myotomy, following total laryngectomy with partial pharyngectomy.

Study design:

Prospective clinical trial.

Setting:

Otolaryngology department, Tanta University Hospital (tertiary referral centre), Egypt.

Patients and methods:

Over five years, 30 patients underwent total laryngectomy with partial pharyngectomy to manage stage III or IV laryngeal cancer, followed by primary tracheoesophageal puncture for voice restoration. For neopharyngeal construction, 15 patients underwent pharyngoesophageal myotomy (group one) and 15 cross-over, zigzag neopharyngoplasty (group two). Acoustic parameters of tracheoesophageal voice were compared.

Results:

Most acoustic parameters were almost equivalent for the two groups, although significant differences were seen for loud intensity, dynamic range, shimmer, loud fundamental frequency, loud jitter, fluency and speaking rate. One post-operative pharyngocutaneous fistula (6.6 per cent) occurred in each group, and resolved with conservative measures.

Conclusion:

The cross-over neopharyngoplasty modification of hypopharyngeal closure may help avoid pharyngoesophageal spasm and assist maintenance of effective voice amplitude, fundamental frequencies, temporal measures and perceptual values.

Keywords

Voice Production, AlaryngealTracheoesophageal FistulaLaryngectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 8 , August 2011 , pp. 841 - 848
Copyright
Copyright © JLO (1984) Limited 2011

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