Logopedics, phoniatrics, vocology · 2025
Comprehensive evaluation of voice and communication experiences after laryngectomy and analysis of the pharyngoesophageal mucosa using high-speed video technology.
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Laksar Klarić Željka, Včeva Andrijana, Živković Ivanović Tamara, Kralik Kristina, Đanić Hadžibegović Ana
Аннотация
INTRODUCTION: This study investigates the relationship between the morphological characteristics of the pharyngoesophageal segment (PES), communication experiences, and the acoustic parameters of the tracheoesophageal (TE) voice.
METHODS: A total of 55 patients who had undergone total laryngectomy were enrolled in this study between July 2020 and October 2023 in a Department of Otorhinolaryngology at a University Hospital in Croatia. High-speed videoendoscopy (HSV) images of the PES mucosa, an objective assessment of the voice, and a self-assessment questionnaire were analysed.
RESULTS: HSV-based visualisation of PES was clearer in individuals who both self-rated their voice more positively and were rated similarly by a Speech and Language Therapist. The most common shape of PES during the open phase was split side-to-side. The Self-Evaluation of Communication Experiences after Laryngectomy (SECEL:HR) questionnaire showed that the majority of patients were well rehabilitated and satisfied with their voice. A significant correlation was found between the fundamental frequency (fo), jitter and shimmer and the SECEL:HR questionnaire. The visibility and shape of the PES as well as the amount of saliva could be associated with the reported fo and the quality of the TE voice.
CONCLUSION: A better insight into the phonatory movement of the PES mucosa in laryngectomised patients could allow us to better assess the patient's abilities and adjust the duration of voice therapy for each patient. However, due to the high variability of anatomical and morphological variations as well as acoustic measurements limiting the final results, further analyses are needed to clarify the different questions raised.
METHODS: A total of 55 patients who had undergone total laryngectomy were enrolled in this study between July 2020 and October 2023 in a Department of Otorhinolaryngology at a University Hospital in Croatia. High-speed videoendoscopy (HSV) images of the PES mucosa, an objective assessment of the voice, and a self-assessment questionnaire were analysed.
RESULTS: HSV-based visualisation of PES was clearer in individuals who both self-rated their voice more positively and were rated similarly by a Speech and Language Therapist. The most common shape of PES during the open phase was split side-to-side. The Self-Evaluation of Communication Experiences after Laryngectomy (SECEL:HR) questionnaire showed that the majority of patients were well rehabilitated and satisfied with their voice. A significant correlation was found between the fundamental frequency (fo), jitter and shimmer and the SECEL:HR questionnaire. The visibility and shape of the PES as well as the amount of saliva could be associated with the reported fo and the quality of the TE voice.
CONCLUSION: A better insight into the phonatory movement of the PES mucosa in laryngectomised patients could allow us to better assess the patient's abilities and adjust the duration of voice therapy for each patient. However, due to the high variability of anatomical and morphological variations as well as acoustic measurements limiting the final results, further analyses are needed to clarify the different questions raised.