Article

Laryngeal function after supracricoid laryngectomy.

Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan.
Otolaryngology Head and Neck Surgery (impact factor: 1.72). 05/2009; 140(4):487-92. DOI:10.1016/j.otohns.2008.12.036 pp.487-92
Source: PubMed

ABSTRACT The purpose of this study was to assess laryngeal function after supracricoid laryngectomy.
Case series.
Supracricoid laryngectomy (SCL) has been performed in our institution for 24 selected patients with laryngeal cancer since December 2000. Reconstruction was performed through cricohyoidoepiglottopexy for 23 patients and cricohyoidopexy for 1 patient. Seven patients had ipsilateral arytenoid removal, and 15 patients underwent SCL as salvage surgery. A retrospective chart review was performed to assess postoperative speech and swallowing function. Stroboscopy and/or fiberscopy of the neoglottis were used to assess postoperative speech kinetics. Acoustic parameters were measured to evaluate vocal function, and several questionnaires were used to evaluate postoperative quality of life (QOL).
In the absence of postoperative complications, stoma closure and normal diet intake were achieved 1 month after surgery. The neoglottis comprises the arytenoid(s), epiglottis, and pyriform sinus mucosa. Several different combinations of vibrating regions were observed among patients during phonation. Although vocalization sounded rough and breathy, vocal communication was possible with little inconvenience.
Acceptable functional recovery and tolerable QOL can be achieved after SCL.

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    Article: Quality of voice evaluation in patients treated by supracricoid laryngectomy and modified supracricoid laryngectomy.
    Eugenia Allegra, Nicola Lombardo, Alessandro La Boria, Giuseppe Rotundo, Maria Rita Bianco, Tiziana Barrera, Manuela Cuccunato, Aldo Garozzo
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    ABSTRACT: To compare quality of voice in patients treated by supracricoid laryngectomy and patients treated by modified supracricoid laryngectomy using the sternohyoid muscle for neoglottis reconstruction. Case series. Setting. Teaching hospital. This study was performed between 2004 and 2008 on 28 consecutive patients affected by T1b-T2 laryngeal carcinoma. Eleven patients were treated by supracricoid laryngectomy, and 17 patients were treated by modified supracricoid laryngectomy. For each patient, postoperative parameters such as decannulation time, nasogastric feeding tube, and length of hospitalization were noted. Vocal function, Voice Handicap Index scores, and perceptual voice analysis scores on intelligibility, noise, fluency, and voice scale were evaluated. The postoperative course of the patients treated by modified supracricoid laryngectomy was similar to patients treated by supracricoid laryngectomy. No delay in the length of hospitalization was detected in patients undergoing surgery with the new technique. A significant difference was detected in the nasogastric tube removal time and decannulation time. The data from intelligibility, noise, fluency, and voice scale analyses revealed a better quality of voice in patients treated by modified supracricoid partial laryngectomy with a significant difference in intelligibility, fluency, and voicing. The Voice Handicap Index mean value of physical, functional, and emotional subscales confirmed patients' perceptions of a minor voice handicap in patients treated by modified supracricoid laryngectomy, with a significant difference on the physical subscale. Modified supracricoid laryngectomy seems to be a good way to improve quality of voice and quality of life in patients with early laryngeal cancer.
    Otolaryngology Head and Neck Surgery 07/2011; 145(5):789-95. · 1.72 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

1 month
 
1 patient
 
15 patients
 
23 patients
 
Acceptable functional recovery
 
Case series
 
different combinations
 
laryngeal cancer
 
laryngeal function
 
normal diet intake
 
postoperative complications
 
postoperative quality
 
postoperative speech
 
postoperative speech kinetics
 
retrospective chart review
 
swallowing function
 
vibrating regions
 
vocal communication
 
vocal function
 
vocalization sounded rough
 

Koichiro Saito