title: Effect of primary, cross-over, zigzag neopharyngoplasty on acoustic characteristics of alaryngeal, tracheoesophageal voice.
abstract: OBJECTIVE
  To evaluate the effect of primary, cross-over, zigzag neopharyngeal construction on tracheoesophageal voice, compared with pharyngoesophageal myotomy, following total laryngectomy with partial pharyngectomy.
  
  
  METHODS
  Prospective clinical trial.
  
  
  METHODS
  Otolaryngology department, Tanta University Hospital (tertiary referral centre), Egypt.
  
  
  METHODS
  Over five years, 30 patients underwent total laryngectomy with partial pharyngectomy to manage stage III or IV laryngeal cancer, followed by primary tracheoesophageal puncture for voice restoration. For neopharyngeal construction, 15 patients underwent pharyngoesophageal myotomy (group one) and 15 cross-over, zigzag neopharyngoplasty (group two). Acoustic parameters of tracheoesophageal voice were compared.
  
  
  RESULTS
  Most acoustic parameters were almost equivalent for the two groups, although significant differences were seen for loud intensity, dynamic range, shimmer, loud fundamental frequency, loud jitter, fluency and speaking rate. One post-operative pharyngocutaneous fistula (6.6 per cent) occurred in each group, and resolved with conservative measures.
  
  
  CONCLUSIONS
  The cross-over neopharyngoplasty modification of hypopharyngeal closure may help avoid pharyngoesophageal spasm and assist maintenance of effective voice amplitude, fundamental frequencies, temporal measures and perceptual values.
authors: Otolaryngology Department, Tanta University Hospital, Tanta, Egypt. albirmawy@hotmail.com
authors: O A
authors: OA
authors: Albirmawy
mesh_terms: D000368:Aged; D004534:Egypt; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000534:rehabilitation / Q000601:surgery; D007825:Laryngectomy / Q000534:rehabilitation; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods* / Q000534:rehabilitation; D010611:Pharyngectomy / Q000534:rehabilitation; D010614:Pharynx / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000379:methods*; D013035:Spasm / Q000209:etiology / Q000517:prevention & control; D013061:Speech Acoustics; D013072:Speech, Esophageal; D013536:Suture Techniques; D014138:Tracheoesophageal Fistula / Q000453:epidemiology; D016896:Treatment Outcome; D014833:Voice Quality / Q000502:physiology*