[Morphology of the glottis and perceptiv-acoustic characteristic of the voice and speech after extended fronto-lateral epiglotttoplasty].
For optimalisation glottis morphology and its phonatory function after frontolateral laryngectomy (FLL) the reconstruction of larynx is made; in Clinic of Otolaryngology the most common is using epiglottis wit or without its vertical incision.


OBJECTIVE
the influence of widening laryngeal resection and epiglottis incision on shape of reconstructed glottis, level and degree of phonatory closure and perceptive--acoustic characteristic of voice and speech.


METHODS
39 patients (38 M and 1 F) after FLL widened of false vocal cord (n = 11), false vocal cord and part of cricoid cartilage (n = 22), whole cricoid cartilage (n = 6). Vertical incision of epiglottis was made in 31 cases. Mean age was 52 (min.-39, max.-70) years. METHODICS: videolaryngoscopic examination, subjective voice estimation using GRBAS scale, objective phonetic--acoustic voice analysis.


RESULTS
In videolaryngoscopic examination the most common shape of glottis was irregular triangle (n = 24), rhombus (n = 7), half--moon (n = 2), irregular (n = 6). 2 patients were using whisper. In spectrographic recordings (n = 39) only noise character of stimulation source was in 2 patients, noise--periodic with noise component present in whole acoustic spectrum in 37. F0 for single word and sentence vocalized in affirmative and interrogative form had the value of male voices and its changes during speaking were well noted. In subjective and objective estimation, the worse voice quality was after FLL widened of false vocal cord, part or whole cricoid cartilage.


CONCLUSIONS
1) FLL with subsequent epiglottoplasty in 94% of patients makes satisfactory morphologic and biophysical conditions for production of voice and sociological efficient speech. 2) Widening resection of false vocal cord, part or whole cricoid cartilage has unbeneficial influence on perceptive--acoustic characteristic of voice and speech.
Tarnowska
Czesława
C
Katedra i Klinika Otolaryngologii i Onkologii Laryngologicznej PAM. kkotlar@sci.pam.szczecin.pl
Kawczyński
Maciej
M
Just
Marcin
M
Amernik
Katarzyna
K
Jaworowska
Ewa
E
Lubiński
Jakub
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003413:Cricoid Cartilage / Q000601:surgery*; D004825:Epiglottis / Q000601:surgery*; D005260:Female; D005931:Glottis / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011044:Poland; D011184:Postoperative Period; D013061:Speech Acoustics; D013065:Speech Intelligibility; D013072:Speech, Esophageal / Q000379:methods; D014832:Voice Disorders / Q000209:etiology; D014833:Voice Quality; D014834:Voice Training