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Ann Acad Med Stetin, 2006; 52, 1, 125-135

BEATA PARADOWSKA-OPAŁKA

MORPHOLOGY OF THE GLOTTIS AFTER SUPRACRICOID LARYNGECTOMY WITH CHP OR CHEP AND RESTORATION OF BASIC LARYNGEAL FUNCTION WITH SPECIAL ATTENTION TO QUALITY OF PHONATION

Katedra i Klinika Otolaryngologii i Onkologii Laryngologicznej Pomorskiej Akademii Medycznej

ul. Unii Lubelskiej 1, Szczecin

Kierownik: prof. dr hab. n. med. Czesława Tarnowska

Summary

Purpose: The aim of this work was to describe the morphology of the reconstructed larynx after supracricoid horizontal laryngectomy with simultaneous cricohyopexy (CHP) or cricohyoepiglottopexy (CEHP) preserving one or both arytenoid cartilages, to study the protective and respiratory functions of the larynx, to perform phoniatric evaluation of phonation quality, to analyze voice and speech phonetic-acoustic parameters, and to search for correlations between reconstruction type and phonetic-acoustic characteristics of voice and speech.

Material and methods: The material comprised 58 patients (32 after CHP and 26 after CHEP).

Conclusion: Oval shape of the neoglottis dominated. Swallowing was normal in 46% of patients and did not depend on reconstruction type. Decannulation was possible in 66% of patients. The results were inferior after CHEP with both arytenoid cartilages intact. Socially efficient speech was found in 74% of patients and the results were better with CHEP. The phonetic-acoustic structure of voice and resonant speech was considerably different from the phonetic-acoustic structure of voice and speech under physiologic conditions. These differences applied to segmental (formant structure frequencies, noise range), as well as suprasegmental voice features.

K e y w o r d s: supracricoid laryngectomy – cricohyopexy – cricohyoepiglottopexy – swallowing – respiration – phonation.

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