Speech Performance after Anterolateral Thigh Phonatory Tube Reconstruction for Total Laryngectomy.
Free Tissue Flaps
Humans
Laryngectomy
/ adverse effects
Larynx, Artificial
Male
Middle Aged
Pharyngectomy
/ adverse effects
Phonation
/ physiology
Postoperative Complications
/ etiology
Plastic Surgery Procedures
/ methods
Retrospective Studies
Speech
/ physiology
Speech Intelligibility
Speech Production Measurement
Speech, Alaryngeal
/ methods
Taiwan
Thigh
/ surgery
Treatment Outcome
Voice Disorders
/ etiology
Voice Quality
ALT flap
Laryngeal cancer
speech
total laryngectomy
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
19
06
2020
received:
01
04
2020
accepted:
20
07
2020
pubmed:
7
12
2020
medline:
19
5
2021
entrez:
6
12
2020
Statut:
ppublish
Résumé
Traditionally, after total laryngopharyngectomy (TLP), patients cannot speak without a prosthesis or an artificial larynx. In Taiwan, most patients use a commercialized pneumatic laryngeal device (PLD). Phonatory tube reconstruction with the anterolateral thigh (ALT) flap is a novel, modified version of synchronous digestive and phonatory reconstruction involving a free muscular cutaneous flap. This study reviewed and compared speech performance between patients who underwent novel flap reconstruction and conventional PLD users. We retrospectively reviewed patients with laryngeal or hypopharyngeal cancer who underwent TLP from August 2017 to September 2019. The voice handicap index (VHI), speech intelligibility, acoustic and aerodynamic analysis results, and speech range profile (SRP) were compared between patients who underwent ALT phonatory tube reconstruction (ALT group) and those using PLDs (PLD group). Twenty patients were included; 13 patients were included in the ALT group, and 7 patients were included in the PLD group. Compared to the PLD group, the ALT group had a better fundamental frequency range (P < .001) and semitone range (P < .001) during speech but showed worse jitter, shimmer, and harmonic-to-noise ratios. The two groups showed comparable VHI and speech intelligibility performance. The ALT phonatory tube, a novel flap for reconstruction, can restore digestive and voice functions simultaneously. Compared with PLD use, ALT phonatory tube reconstruction yields an improved speech range and comparable levels of voice handicap and speech intelligibility, suggesting that the technique is a good alternative for patients after TLP. 4 Laryngoscope, 131:1349-1357, 2021.
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1349-1357Subventions
Organisme : Chang Gung Medical Foundation
ID : CMRPG3G1241
Organisme : Ministry of Science and Technology grant
ID : MOST107-2314-B-182A-084-MY3
Informations de copyright
© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).
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