Voice and deglutition functions after the supracricoid and total laryngectomy procedures for advanced stage laryngeal carcinoma.
OBJECTIVE
This investigation compared speech and deglutition functions after alternative surgical treatments for advanced stage laryngeal carcinoma: the supracricoid laryngectomy (SCL) versus the total laryngectomy (TL). Study design and setting Cohort investigation at Wayne State University School of Medicine.


METHODS
Quantitative studies of laryngeal biomechanics, acoustic and speech aerodynamic features, and deglutition skills of these individuals were coupled to listener and patient self-impressions of speech and voice characteristics for group comparative analyses.


RESULTS
Results revealed that patients from each subgroup performed comparably relative to speech intelligibility and voice quality disturbances. Videostroboscopy of the neoglottal mechanisms in these two populations helped to explain these outcomes. Acoustic and speech aerodynamic testing demonstrated variably abnormal features in both surgical subgroups. Whereas the SCL patients eventually achieved full oral diets, they required many sessions of swallowing therapy to obtain this objective and eliminate tube feeding supplementation. The TL patients did not evidence protracted swallowing difficulties or the need for specific exercises in order to remove their feeding tubes postoperatively. References to organ preservation strategies in lieu of surgical management are included for completeness purposes.


CONCLUSIONS
The SCL and TL surgical procedures for advanced stage laryngeal carcinoma resulted in equivalent speech and swallowing functional outcomes.
Department of Otolaryngology, Head and Neck Surgery, Wayne State University, School of Medicine, Detroit, MI, USA. aa1544@wayne.edu
James Paul
JP
Dworkin
Robert J
RJ
Meleca
Mark A
MA
Zacharek
Robert J
RJ
Stachler
Raza
R
Pasha
G G
GG
Abkarian
Richard A
RA
Culatta
John R
JR
Jacobs
D001696:Biomechanical Phenomena; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007820:Laryngeal Mucosa / Q000502:physiology; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D017060:Patient Satisfaction; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012720:Severity of Illness Index; D013061:Speech Acoustics; D013065:Speech Intelligibility; D014732:Vibration; D014832:Voice Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014833:Voice Quality