Phonosurgical treatments following total laryngectomy and post-operative vocal function

Abstract

This paper describes the results of Arslan-Serafini technique in 11, Amatsu technique in 15 and Panje technique in 1 case. Post-operative vocal function was evaluated in 3 Arslan-Serafini, 5 Amatsu and 1 Panje case. Following Arslan-Serafini operation, 7 patients became able to speak, whereas in the other 4, the shunt was closed spontaneously or because of infection and/or necrosis. Of the former 7, 6 patients had no or only slight aspiration but the other patient suffered from severe aspiration and, therefore, we had to close the shunt surgically. Following Amatsu operation, 5 patients obtained phonatory and protective functions. In other 3 patients who became able to phonate, the shunt had to be closed because of severe aspiration. In the remaining 7, the shunt was closed spontaneously or because of infection and/or necrosis. The patient who underwent Panje method became able to speak. There was no difference in phonatory function among the 3 phonosurgical treatment modalities. Compared to normal subjects, the fundamental frequency of voice was low, the ranges of frequency and intensity of voice were narrow and the glottal resistance and subglottal pressure were high.