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

Albirmawy, Osama A.

doi:10.1017/s0022215111000910

Cited by 3 publications

(5 citation statements)

References 25 publications

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“…One study also suggests that these modified methods may be performed in combination with pharyngoesophageal myotomy to minimize the intra-luminal pressure of the neopharynx which may lead to an improved voice outcome [80]. Currently, these additional or modified techniques have shown more success in voice restoration than the traditional three-layer closure, and are associated with lower rates of voice restoration failure (between 0% and 10%) [77,[79][80][81][82][83][84]. Based on the literature, pharyngoesophageal myotomy is the most commonly used technique [74][75][76][77]79,80,83,84].…”

Section: The Submucosal and Muscular Layersmentioning

confidence: 99%

Total Laryngectomy: A Review of Surgical Techniques

Chotipanich

2021

Cureus

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Since the first total laryngectomy was performed in the late 18th century, several improvements and variations in surgical techniques have been proposed for this procedure. The surgical techniques employed in total laryngectomy have not been comprehensively discussed to date. Thus, the main objective of this article was to address controversial aspects related to this procedure and compare different surgical techniques used for a total laryngectomy procedure from the beginning to the end.Although the management paradigms in laryngeal and hypopharyngeal squamous cell carcinomas have shifted to organ-preserving chemoradiotherapy protocols, total laryngectomy still plays a prominent role in the treatment of advanced and recurrent tumors. The increased incidence of complications associated with salvage total laryngectomy has driven efforts to improve the surgical techniques in various aspects of the operation. Loss of voice and impaired swallowing are the most difficult challenges to be overcome in laryngectomies, and the introduction of tracheoesophageal voice prostheses has made an enormous difference in postoperative rehabilitation and quality of life. Advancements in reconstruction techniques, tumor control, and metastatic management, such as prophylactic neck treatments and paratracheal nodal dissection (PTND), as well as the use of thyroid gland-preserving total laryngectomy in selected patients have all led to the increasing success of modern total laryngectomy. Several conclusions regarding the benchmarking of surgical techniques cannot be drawn. Issues regarding total laryngectomy are still open for discussion, and the technique will continue to require improvement in the near future.

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Section: The Submucosal and Muscular Layersmentioning

confidence: 99%

Total Laryngectomy: A Review of Surgical Techniques

Chotipanich

2021

Cureus

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“…In a recent prospective, double‐arm study, Albirmawy23 evaluated the effect of primary, crossover, “zigzag” neopharyngeal construction (as a novel technique) on primary T‐E voice, compared with pharyngoesophageal myotomy (as a standard technique), following total laryngectomy with partial pharyngectomy. He concluded that the crossover zigzag neopharyngoplasty modification of hypopharyngeal closure may help avoid pharyngoesophageal spasm and assist maintenance of effective voice.…”

Section: Introductionmentioning

confidence: 99%

“…Acoustic characteristics of T‐E speech have been studied following different surgical modalities used to address the neopharynx. One commonly followed method of acoustic analysis is the use of acoustic signals to assess different quantitative and qualitative parameters 17, 23, 29. Patients are asked to produce a sustained “A” at a comfortable pitch and at a conversational loudness level, on a single deep breath for as long as possible, over three successive trials.…”

Section: Introductionmentioning

confidence: 99%

“…Data from the perceptual evaluation should be correlated with the quantitative voice parameters. This has enabled the investigators to identify parameters that are meaningful and clinically relevant 23. Perceptual analysis of T‐E voice has traditionally been considered the gold standard for evaluation of alaryngeal voice.…”

Section: Introductionmentioning

confidence: 99%

“…Keeping the pharyngoesophageal sphincter intact helps improve voice amplitude and shimmer. In addition, repairing the constrictor muscle flaps in a zigzag fashion helps relax the healing tension line of these muscles, prevent circumferential muscular spasm, reinforce the mucosal suture line, and maintain a critical level of myoelastic tonicity to facilitate successful phonation, resulting in favorable results for amplitude fundamental frequencies, jitter, temporal measures, and perceptual values 23…”

Section: Introductionmentioning

confidence: 99%

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Contemporary Review: Impact of primary neopharyngoplasty on acoustic characteristics of alaryngeal tracheoesophageal voice

et al. 2012

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The physiology of the vibratory mechanism in alaryngeal tracheoesophageal speech depends on several factors. The structure and resulting function of the neoglottis (or neopharynx) varies from patient to patient depending on the individual details of the surgical procedure performed, as well as the patient's anatomy. In general, the vibratory segment is a blending of the pharyngeal constrictor muscles, cricopharyngeus, and upper circular fibers of the esophagus. Limited ability to visualize dynamically these three-dimensional structures during rapid events of voice and speech production impedes complete understanding of the vibratory function of the neopharynx. Acoustic studies have elucidated some general characteristics of the pharyngoesophagus and neoglottic vibratory mechanism in the laryngectomized population. A critical degree of tonicity is necessary for apposition of mucosal surfaces in the production of tracheoesophageal voice. Deficiencies in the vibratory segment can usually be managed with various surgical procedures (neopharyngoplasty), resulting in reduced intraesophageal pressure and corresponding increase in fluent, intelligible, effortless speech. The acoustic measures, when correlated with neopharyngoplasty variables, produce many significant associations. Some of them are paramount and deserve further attention.

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Alaryngeal Speech Enhancement for Noisy Environments Using a Pareto Denoising Gated LSTM

Maskeliūnas,

Damaševičius,

Kulikajevas

et al. 2024

Journal of Voice

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

Abstract: 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.

Cited by 3 publications

References 25 publications

Total Laryngectomy: A Review of Surgical Techniques

Total Laryngectomy: A Review of Surgical Techniques

Contemporary Review: Impact of primary neopharyngoplasty on acoustic characteristics of alaryngeal tracheoesophageal voice

Alaryngeal Speech Enhancement for Noisy Environments Using a Pareto Denoising Gated LSTM

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