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Effect of primary, cross-over, zigzag neopharyngoplasty on acoustic characteristics of alaryngeal, tracheoesophageal voice

O A Albirmawy^a1 c1

^a1 Otolaryngology Department, Tanta University Hospital, Egypt

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.

Study design: Prospective clinical trial.

Setting: Otolaryngology department, Tanta University Hospital (tertiary referral centre), Egypt.

Patients and 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.

Conclusion: 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.

(Accepted December 15 2010)

(Online publication June 07 2011)

Key words

• Voice Production, Alaryngeal;
• Tracheoesophageal Fistula;
• Laryngectomy

Correspondence:

^c1 Address for correspondence: Dr Osama Amin Albirmawy, 88 Reyad St, Tanta 31211, Gharbeya, Egypt E-mail: albirmawy@hotmail.com

Dr O A Albirmawy takes responsibility for the integrity of the content of the paper

Competing interests: None declared