Vocal analysis after vertical partial laryngectomy.

Abstract

It is generally believed that a reconstruction of the glottic region after a vertical partial laryngectomy (VPL) can improve the glottic and supraglottic function. However, there is a paucity of reports on secondary healing without a glottic reconstruction after a VPL. The aim of this study was to obtain objective phonatory data after a VPL without a glottic reconstruction. From 1993 to 2001, 13 patients, who had been treated with VPL without a glottic reconstruction, were enrolled in this study. Patients with a postoperative follow up of less than 12 months were excluded. Seven lesions were classified as T1 glottic cancer and six as T2 glottic cancer- standard VPL (11 cases) and frontolateral VPL (2 cases). Acoustic ((fundamental frequency, Fo), jitter, shimmer, the noise to harmonic ratio (NHR)), aerodynamic (maximal phonation time (MPT), mean flow rate (MFR)) analysis and videostroboscopy were performed to evaluate the voice. There were significant differences in the Fo, jitter, shimmer, NHR, MPT and MFR between the VPL group and normal control group. In videostroboscopy, the following tendencies were observed in many cases: incomplete glottic closure, a decreased and irregular mucosal wave and amplitude, supraglottic voicing, abnormal arytenoid movement and anterior commissure blunting. Objective phonatory data after VPL without a glottic reconstruction was obtained. The voice quality after a VPL without a glottic reconstruction was somewhat unsatisfactory. A further comparison with other different surgical techniques of a VPL would help determine a better way of improving the voice quality in these patients.