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Perceptual and objective assessment of speech intelligibility and factors affecting it after supracricoid laryngectomy

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Phoniatrics

Advisors

Refaei, Muhammad S. , Aziz, Azza A. , Habib, Emad E.

Authors

Zaytoun, Rehab Abdel-Hafizh

Accessioned

2017-04-26 12:37:43

Available

2017-04-26 12:37:43

type

M.Sc. Thesis

Abstract

The supracricoid partial laryngectomy (SCPL) was developed in the late1950s as an alternative to TL. SCPL has the advantages of preservation of speechand swallowing function without a permanent stoma and a very high local controlrate for selected glottic and supraglottic cancers.Two types of SCPL are employed for distinctly different typesof laryngeal cancers. The differences in the extent of resection achieved by theseforms of SCPL require discrete reconstructions. The true and false cords, bothparaglottic spaces, and the entire thyroid cartilage are resected in the SCPL that isused to treat selected glottic carcinomas. The reconstruction requires suturing thecricoid to the hyoid and the epiglottis, termed a cricohyoidoepiglottopexy (CHEP).The second form of the procedure, which is employed to ablate selectedtransglottic and supraglottic carcinomas, results in the resection of both true andfalse cords, both paraglottic spaces, the entire preepiglottic space, the epiglottis,and the entire thyroid cartilage. The reconstruction for this more extensivetechnique is accomplished by suturing the cricoid to the hyoid, termed acricohyoidopexy (CHP).Because no vocal or false cords are present in the postoperative view ofthe SCPL with CHEP, the normal V-shaped glottis is changed to a T shape inwhich the arytenoids abut each other and the epiglottis anteriorly.The postoperative anatomic configuration is different following SCPLwith CHP because the epiglottis is also resected in this procedure. In this case, the neolarynx is T-shaped, with the arytenoids abutting eachother in the midline and against the tongue base.The phonatory ability of the residual larynx has to be completely reestimated, due to the altered anatomo-physiology of the structure after surgery, infact, the residual larynx determines a definitely reduced periodic acoustic signal,rich in noise. Good phonatory results of this treatment are basically due topreservation of intelligible speech which, by ensuring the subjects’ speech ability,overcomes and has little influence on the disturbed quality of the vocal signal inthese patients. However, the patient obtains a “new voice” as far as concernsacoustic features and this is very important for communication and social life,moreover, the possibility of objectively estimating acoustic vocal function abilityallows monitoring of the trend and results of possible speech therapy and/orphonosurgical rehabilitation treatment which should start from new anatomical andphysiological bases, as well as from the new physical acoustic mechanism of signalproduction.

Issued

1 Jan 2011

DOI

http://dx.doi.org/10.21473/iknito-space/33351

Details

Type

Thesis

Created At

28 Jan 2023