title: Voice and swallowing disorders: functional results and quality of life following supracricoid laryngectomy with cricohyoidoepiglottopexy.
abstract: We conducted a prospective study of 11 patients with laryngeal cancer who underwent supracricoid laryngectomy with cricohyoidoepiglottopexy. Our goal was to evaluate their postoperative voice and swallowing function and to ascertain the impact that surgery had on patient-perceived quality of life. Postoperative assessments were made by auditory perception analyses, objective voice analyses, the Voice Handicap Index questionnaire, the Quality of Life in Swallowing Disorders questionnaire, and videofluoroscopy. Following surgery, 8 patients experienced severe dysphonia and 3 experienced moderate dysphonia. Also, 5 patients experienced mild to severe dysphagia whereas 6 patients experienced normal or near-normal swallowing function. Postoperative acoustic measurements were higher than expected, and spectrographic evaluation revealed the presence of high-grade noise without predominant concentration over the spectrum. Some association with the grade of dysphonia and self-perception of voice handicap was observed. With regard to swallowing, 5 patients (45.5%) showed a decrease in laryngeal remnant elevation and a slight or moderate degree of stasis in the oropharynx. Overall, patients reported good quality of life regarding both voice and swallowing. No relationship between the functional swallowing and the number of preserved arytenoid cartilages was observed.
authors.affiliation: Department of Voice, Speech, and Swallowing Rehabilitation, Hospital Heliópolis, São Paulo, Brazil.
authors.forename: Juliana Godoy
authors.initials: JG
authors.lastname: Portas
authors.forename: Débora dos Santos
authors.initials: Ddos S
authors.lastname: Queija
authors.forename: Leonora Pereira
authors.initials: LP
authors.lastname: Arine
authors.forename: Alessandra Sampaio
authors.initials: AS
authors.lastname: Ferreira
authors.forename: Rogério A
authors.initials: RA
authors.lastname: Dedivitis
authors.forename: Carlos Neutzling
authors.initials: CN
authors.lastname: Lehn
authors.forename: Ana Paula Brandão
authors.initials: AP
authors.lastname: Barros
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D003413:Cricoid Cartilage / Q000601:surgery*; D003680:Deglutition Disorders / Q000209:etiology* / Q000523:psychology*; D004825:Epiglottis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology* / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D018714:Radiotherapy, Adjuvant; D012815:Signal Processing, Computer-Assisted; D013018:Sound Spectrography; D014832:Voice Disorders / Q000209:etiology* / Q000523:psychology; D014833:Voice Quality