Acoustic and aerodynamic measurement of speech production after supracricoid partial laryngectomy.
BACKGROUND
Supracricoid partial laryngectomy (SCPL) results in laryngeal preservation in more than 95% of patients with T2 glottic carcinoma. After surgery, glottis function is characterized by an absence of vocal cords and poor glottis closure. Voice is an important postSCPL quality of life factor.


OBJECTIVE
Enhance postSCPL vocal function. Obtain postsurgical acoustic and aerodynamic measurements and correlate multiple objective parameters with perceptual results.


METHODS
Continuous speech voice samples from 61 patients who had undergone SCPL more than 1 year before were scored according to the global, roughness, breathiness, asthenia, and strain (GRBAS) scale by a jury of listeners. Acoustic and aerodynamic parameters were recorded: fundamental frequency (F0), intensity, jitter, shimmer, signal-to-noise ratio (SNR), signal-to-noise ratio greater than 1 kHz (SNR>1), oral airflow (OAF), maximum phonation time (MPT), and estimated subglottic pressure (ESGP). Nonparametric tests and logistic regression analysis were used to compare objective measurements and perceptual evaluations.


RESULTS
All patients had various degrees of dysphonia: grade 1, 4.9%; grade 2, 55.7%; and grade 3, 39.4%. Correlations between perceptual grades and objective parameters were obtained for jitter, shimmer, SNR, SNR>1, ESGP, and OAF. No correlations were obtained between the different parameters and age, number of arytenoids, and time elapsed since surgery (TESS). Logistic regression analysis of jitter, SNR, ESGP, and OAF parameters revealed 92.6% agreement with the perceptual evaluation results.
Makeieff
Marc
M
Service ORL chirurgie Cervico-Faciale, Hôpital Gui de Chauliac, Université de Médecine, Montpellier, France. m-makeieff@chu-montpellier.fr
Barbotte
Eric
E
Giovanni
Antoine
A
Guerrier
Bernard
B
D005260:Female; D006801:Humans; D007825:Laryngectomy / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013061:Speech Acoustics; D013068:Speech Production Measurement; D013071:Speech, Alaryngeal; D014827:Vocal Cords / Q000503:physiopathology; D014832:Voice Disorders / Q000503:physiopathology; D014833:Voice Quality