Topaloğlu Ilhan, Salturk Ziya, Atar Yavuz, Berkiten Güler, Büyükkoç Onur, Çakır Ozan
Yeditepe University Faculty of Medicine, Ear Nose and Throat Clinic, İstanbul, Turkey
Okmeydanı Training and Research Hospital Ear Nose and Throat Clinic, İstanbul, Turkey.
Otolaryngol Head Neck Surg. 2014 Dec;151(6):1003-7. doi: 10.1177/0194599814554763. Epub 2014 Oct 10.
Supraglottic laryngectomy is a surgical procedure that preserves laryngeal functions. This technique allows extensions including removal of tongue base or 1 arytenoid. We aimed to compare vocal results of supraglottic laryngectomy and extended procedures.
Cross-sectional study.
Tertiary care hospital.
Thirty-three males who underwent supraglottic laryngectomy were included in the study. Fifteen patients (45.5%) were applied standard supraglottic laryngectomy (standard supraglottic laryngectomy group). In 11 patients (33.3%), unilateral arytenoid cartilage was totally resected by separation at the cricoarytenoid joint (laterally extended group), and the tongue base was removed in 7 patients (anteriorly extended group) (21.2%). Twenty male smokers constituted control group. Acoustic and aerodynamic voice analyses were performed for the assessment of objective results. Grade, roughness, breathiness, asthenia, and strain scale (GRBAS) scores were analyzed for perceptual assessment. Voice Handicap Index-30 was used to evaluate subjective results.
The comparison of supraglottic laryngectomy group with the control group revealed that the mean maximum phonation time and fundamental frequency were significantly lower in the supraglottic laryngectomy group (P < .001), and the mean jitter, shimmer, and noise-to-harmonics ratio were significantly higher in the supraglottic laryngectomy group (P < .001). Maximum phonation time and fundamental frequency were higher in the standard supraglottic laryngectomy group in comparison to extended groups. Jitter value was also lower in the standard supraglottic laryngectomy group compared to extended groups. Perceptual and subjective analyses revealed no difference among standard supraglottic laryngectomy and extended groups.
The results of this study indicate that supraglottic laryngectomy patients have acceptable voice quality, as determined by perceptual and subjective assessment.
声门上喉切除术是一种保留喉部功能的外科手术。该技术允许进行扩展,包括切除舌根或一侧杓状软骨。我们旨在比较声门上喉切除术和扩展手术的发声结果。
横断面研究。
三级医疗中心。
33例接受声门上喉切除术的男性纳入本研究。15例患者(45.5%)接受标准声门上喉切除术(标准声门上喉切除术组)。11例患者(33.3%)在环杓关节处分离完全切除单侧杓状软骨(侧方扩展组),7例患者(21.2%)切除舌根(前方扩展组)。20名男性吸烟者作为对照组。进行声学和空气动力学嗓音分析以评估客观结果。分析等级、粗糙度、气息声、无力和紧张度量表(GRBAS)评分以进行感知评估。采用嗓音障碍指数-30评估主观结果。
声门上喉切除术组与对照组比较,声门上喉切除术组的平均最长发声时间和基频显著降低(P < .001),平均抖动、闪烁和噪声谐波比显著升高(P < .001)。标准声门上喉切除术组的最长发声时间和基频高于扩展组。标准声门上喉切除术组的抖动值也低于扩展组。感知和主观分析显示标准声门上喉切除术组和扩展组之间无差异。
本研究结果表明,根据感知和主观评估,声门上喉切除术患者的嗓音质量可接受。