Vocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affectinq diverse acoustic parameters.
Introduction. Bilateral recurrent laryngeal nerve paralysis usually occurs after thyroid surgery. In bilateral vocal cord paralysis, the voice is clear or slightly hoarse. The aim of this study was to determine whether the quality of voice and speech significantly deteriorates after the surgical treatment of bilateral recurrent laryngeal nerve paralysis. Material and Methods. The study included 16 patients with bilateral vocal cord paralysis and 16 age-and sexmatched healthy controls. The patients underwent partial arytenoidectomy with posterior cordectomy at the Clinical Center of Vojvodina in the period from January to April 2014. The quality of voice and speech was determined before and after surgical treatment by subjective, objective, aerodynamic voice analysis, and analysis of spontaneous speech, and then compared to the control group. Results. The results of this study showed that in patients with bilateral vocal cord paralysis the voice and speech quality was significantly worse compared to the healthy subjects. The results of subjective and aerodynamic analysis showed that there was a statistically significant deterioration in voice quality after the surgical treatment (p<0.05; p=0.001). The values of objective analysis and analysis of spontaneous speech parameters did not significantly change after the surgery (p>0.05; p=0.401). Conclusion. The patients with bilateral vocal cord paralysis have a poorer voice and speech quality compared to the healthy subjects. After the surgical treatment, patients presented with a lower voice quality, but there were no significant changes regarding the ability of spontaneous speech.
Loss of voice after total laryngectomy propter laryngeal cancer disables a person to successfully communicate with patient environment and can lead to total isolation. Learning esophageal speech in some cases is not successful. Vocal prosthesis insertion can resolve this condition. This retrospective study shows voice and speech rehabilitation in patients after total laryngectomy and installation of voice prostheses. The study included 48 patients (7 women, 41 men) with vocal prosthesis placement. Patients were 44-77years old (mean 62.5). In 7 patients (14.58%) underwent primary installation, and 41 (85.42%) patients with secondary installation of a voice prosthesis. The results of comparative analysis of four basic parameters of voice was found that the maximum phonation time of tracheoesophageal speech (12.5s) shorter than the normal speech (23.5s), and longer compared with esophageal speech (3s). Height tracheoesophageal voice (70-190Hz) is lower than the normal level of voice (150-220Hz) and higher compared with the amount of esophageal voice (70Hz). While the tracheoesophageal voice and speech needs more time for saying 120 phonetically balanced words (2.20min) than normal voice and speech (1.08min) and shorter than esophageal speech (3.05min).
Conclusion:Tracheoesophageal voice and speech with voice prosthesis placement have extremely high success rate (98%), faster rehabilitation and better functional results than esophageal speech.
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