title: Long-term voice and swallowing modifications after supracricoid laryngectomy: objective, subjective, and self-assessment data.
abstract: OBJECTIVE
  The supracricoid laryngectomies (SCLs) are conservative surgical techniques for the treatment of selected laryngeal carcinomas. The advantage of SCL is that a permanent tracheostoma is not required, thus, maintaining the principal laryngeal functions. The aim of the study is to report objective, subjective, and self-assessment long-term results of voice and swallowing in a large group of patients who underwent SCL at least 2 years before this study was undertaken.
  
  
  METHODS
  Twenty male subjects who underwent SCL with a mean age of 71 years (range, 51-82) were involved in a retrospective study on swallowing and vocal function. Videoendoscopic ratings were taken of neoglottic vibration patterns and bolus transit. The maximum phonation time and the syllable diadochokinesis were measured. Spectrograms were recorded. Voices were perceptually rated using the Grade, Instability, Roughness, Breathiness, Asthenicity, Strain (GIRBAS) scale. All of the subjects completed a self-assessment questionnaire for both voice and swallowing.
  
  
  RESULTS
  Videoendoscopic ratings showed moderate to severe impairment of neoglottal vibration, whereas bolus transit appeared only mildly impaired. The mean values of the GIRBAS scale were 2.4, 2.6, 2.4, 0.8, 0.5, and 0.8. The mean maximum phonation time was 7.5 seconds, whereas the mean value of the Yanagihara scale was 3.7 for voice spectrograms. Mean syllable diadochokinesis appeared as 3.3 syllables per second. Voice and swallowing quality of life questionnaires revealed satisfied patients.
  
  
  CONCLUSIONS
  Swallowing after SCL was satisfactory; on the contrary, endoscopic, aerodynamic, perceptual, and acoustic data showed a highly dysphonic voice after SCL. However, self-assessment results revealed relatively satisfied speakers on the emotional, physical, and functional levels.
authors.affiliation: Department of Clinical Sciences, University of Milan, Italy. antonio.schindler@tiscali.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Schindler
authors.forename: Elena
authors.initials: E
authors.lastname: Favero
authors.forename: Silvia
authors.initials: S
authors.lastname: Nudo
authors.forename: Roberto
authors.initials: R
authors.lastname: Albera
authors.forename: Oskar
authors.initials: O
authors.lastname: Schindler
authors.forename: Andrea Luigi
authors.initials: AL
authors.lastname: Cavalot
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003679:Deglutition; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014833:Voice Quality