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Speech Performance after Anterolateral Thigh Phonatory Tube Reconstruction for Total Laryngectomy
Author(s) -
Lu YiAn,
Pei YuCheng,
Chuang HsiuFeng,
Lin LiYun,
Hsin LiJen,
Kang ChungJan,
Huang ShiangFu,
Chiang HuiChen,
Tsao ChungKan,
Fang TuanJen
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29005
Subject(s) - medicine , laryngectomy , intelligibility (philosophy) , larynx , phonation , audiology , surgery , cordectomy , vocal fold paralysis , paralysis , philosophy , epistemology
Objective Traditionally, after total laryngopharyngectomy (TLP), patients cannot speak without a prosthesis or an artificial larynx. In Taiwan, most patients use a commercialized pneumatic laryngeal device (PLD). Phonatory tube reconstruction with the anterolateral thigh (ALT) flap is a novel, modified version of synchronous digestive and phonatory reconstruction involving a free muscular cutaneous flap. This study reviewed and compared speech performance between patients who underwent novel flap reconstruction and conventional PLD users. Method We retrospectively reviewed patients with laryngeal or hypopharyngeal cancer who underwent TLP from August 2017 to September 2019. The voice handicap index (VHI), speech intelligibility, acoustic and aerodynamic analysis results, and speech range profile (SRP) were compared between patients who underwent ALT phonatory tube reconstruction (ALT group) and those using PLDs (PLD group). Results Twenty patients were included; 13 patients were included in the ALT group, and 7 patients were included in the PLD group. Compared to the PLD group, the ALT group had a better fundamental frequency range ( P < .001) and semitone range ( P < .001) during speech but showed worse jitter, shimmer, and harmonic‐to‐noise ratios. The two groups showed comparable VHI and speech intelligibility performance. Conclusions The ALT phonatory tube, a novel flap for reconstruction, can restore digestive and voice functions simultaneously. Compared with PLD use, ALT phonatory tube reconstruction yields an improved speech range and comparable levels of voice handicap and speech intelligibility, suggesting that the technique is a good alternative for patients after TLP. Level of Evidence 4 Laryngoscope , 131:1349–1357, 2021