Videostroboscopic Evaluation of Neoglottis in Alaryngeal Patients after Tracheoesophageal Voice Reconstruction without Prosthesis

Abstract

Objective: To investigate by means of videostoboscopy the characteristics of the neoglottis after total laryngectomy with primary or secondary voice reconstruction using a non-prosthetic tracheoesophageal fistula technique
 Methods: 
 Design: Cross-Sectional Study
 Setting: Tertiary Public Hospital 
 Subjects: Twenty alaryngeal patients
 Results: Videostroboscopy enabled evaluation of the neoglottis in all but two patients with a pectoralis major myocutaneous flap reconstruction of the pharyngoesophageal segment. Pooling of saliva was present in the cranial neoglottic opening in all subjects, but obscured visualization in these two. A circular neoglottic shape was most commonly seen. Vibration of the neoglottis was noted in 90% of all alaryngeal patients and was associated with a regular mucosal wave. Pharyngoesophageal vibration was noted in two thirds of patients. It was associated with a strong mucosal wave, regular vibration and a longer open phase.
 Conclusion: Videostroboscopy confirmed that neoglottic vibration accompanies sound production while pharyngoesophageal vibration may reinforce and enhance voice production in alaryngeal patients with non-prosthetic TE voice reconstruction. 
 
 Keywords: larynx, total laryngectomy, voice reconstruction, tracheoesophageal (te) fistula speech, alaryngeal voice, alaryngeal speech, videostrobe