Voice Change Following Total Laryngectomy Reconstruction

Abstract

Introduction: Tracheo-esophageal voice prostheses are widely used following total laryngectomy. A number of authors have explored safe and effective surgical methods. However, changes in the tracheo-esophageal voice have received little attention. We studied the tracheoesophageal voice trends over time. Materials and Methods: The patients were 7 men and 1 women an average of 64.6±7.2 years old who had undergone total laryngectomy reconstruction. The survey items were CSL 4500（KayPENTAX）and PS-77E（Nagashima Medical Instruments）for the analysis, using the maximum phonation time （MPT）, fundamental frequency, maximum sound pressure, mean air flow rate（MFR）, and range of voice. We statistically analyzed the time course of each item at 1/, 3/, 6/, and 12 months postoperatively（analysis of variance, p<0.05）. In addition, the vowels at each point were analyzed by a sound spectrum, and changes in the formant information were confirmed. Result: the MPT significantly lengthened over time postoperatively（p<0.01）. Regarding the range of voice, although there was no significant difference over time, the frequency band tended to increase. In addition, the sound spectrum gram tended to become clearer as the formant structure progressed. The fundamental frequency, maximum sound pressure, and MFR did not differ markedly over time. Conclusion: In the rehabilitation of the tracheo-esophageal voice, it is important to acquire a stable expiratory volume, teach efficient speech methods, and give consulting to help at each periods.