Neoglottic Activity in Tracheoesophageal Phonation

Mohri, Mitsuhiro; Yoshifuji, Mika; Kinishi, Minoru; Amatsu, Mutsuo

doi:10.1016/s0385-8146(12)80010-1

Cited by 22 publications

(7 citation statements)

References 9 publications

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“…FEES has been used extensively to evaluate swallowing in the head and neck cancer population, [ 30 – 36 ], and aspects of communication following laryngectomy [ 37 – 40 ]. However, the use of FEES to evaluate swallow post laryngectomy has not been reported.…”

Section: Instrumental Assessment Of Swallowingmentioning

confidence: 99%

An Investigation of the Post-laryngectomy Swallow Using Videofluoroscopy and Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

et al. 2018

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This study investigates the post-laryngectomy swallow. Presence and degree of residue on the post-laryngectomy swallow as observed on videofluoroscopy and FEES is described. In addition, videofluoroscopy and FEES are assessed for reliability and inter-instrument agreement. 30 laryngectomy subjects underwent dysphagia evaluation using simultaneous videofluoroscopy and FEES. These were reviewed post-examination by three expert raters using a rating scale designed for this purpose. Raters were blinded to subject details, type of laryngectomy surgery, pairing of FEES and videofluoroscopy examinations and the scores of other raters. There was a finding of residue in 78% of videofluoroscopy ratings, and 83% of FEES ratings. Comparison of the tools indicated poor inter-rater reliability and poor inter-instrument agreement. Dysphagia is an issue post laryngectomy as measured by patient self-report and by instrumental evaluation. However, alternative dysphagia rating tools and dysphagia evaluation tools are required to enable accurate identification and intervention for underlying swallow physiology post laryngectomy.Electronic supplementary materialThe online version of this article (10.1007/s00455-017-9862-7) contains supplementary material, which is available to authorized users.

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Section: Instrumental Assessment Of Swallowingmentioning

confidence: 99%

An Investigation of the Post-laryngectomy Swallow Using Videofluoroscopy and Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

et al. 2018

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“…10 Videostroboscopic fiberoptic endoscopy confirms that TE phonation has two steps, consistent with previous studies. 3 First, the preparatory stage of hypopharyngeal closure which forms a small lumen. Second, the phonatory stage of the vibration of the neoglottis with a definite configuration maintained by hypopharyngeal muscle contraction.…”

Section: Discussionmentioning

confidence: 99%

Videostroboscopic Evaluation of Neoglottis in Alaryngeal Patients after Tracheoesophageal Voice Reconstruction without Prosthesis

Madrid¹,

Ureta²

2009

Philipp. J. Otolaryngol. Head & Neck Surg.

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To investigate by means of videostoboscopy the characteristics of the neoglottis after total laryngectomy with primary or secondary voice reconstruction using a non-prosthetic tracheoesophageal fistula technique. Methods: Design: Cross-Sectional Study Setting: Tertiary Public Hospital Subjects: Twenty alaryngeal patients Results: Videostroboscopy enabled evaluation of the neoglottis in all but two patients with a pectoralis major myocutaneous flap reconstruction of the pharyngoesophageal segment. Pooling of saliva was present in the cranial neoglottic opening in all subjects, but obscured visualization in these two. A circular neoglottic shape was most commonly seen. Vibration of the neoglottis was noted in 90% of all alaryngeal patients and was associated with a regular mucosal wave. Pharyngoesophageal vibration was noted in two thirds of patients. It was associated with a strong mucosal wave, regular vibration and a longer open phase. Conclusion: Videostroboscopy confirmed that neoglottic vibration accompanies sound production while pharyngoesophageal vibration may reinforce and enhance voice production in alaryngeal patients with non-prosthetic TE voice reconstruction.

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“…When the tracheostoma is intentionally occluded for phonation, the voice prosthesis allows one-way pulmonary air passage from the trachea through to the oesophagus 6 . The airflow then sets the cervical oesophagus and lower hypopharynx into vibration, generating an acoustic signal 7,8 . This vibrating part, referred to as the pharyngoesophageal (PE) segment, is located in the lower third of the neck, corresponding to cervical vertebrae from C5 to C7 9 .…”

Section: Introductionmentioning

confidence: 99%

The relationship between biomechanics of pharyngoesophageal segment and tracheoesophageal phonation

Zhang¹,

Cook

Szczęśniak

et al. 2019

Sci Rep

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This study examined the relationship between biomechanical features of the pharyngoesophageal (PE) segment, acoustic characteristics of tracheoesophageal (TE) phonation, and patients’ satisfaction with TE phonation. Fifteen patients using TE phonation after total laryngectomy completed the Voice Symptom Scale (VoiSS) and underwent acoustic voice analysis for cepstral peak prominence (CPP) and relative intensity. High resolution manometry (HRM) combined with videofluoroscopy was used to evaluate PE segment pressure and calculate the pressure gradient (ΔP), which was the pressure difference between the upper oesophagus and a point two centimetres above the vibrating PE segment. The upper oesophageal sphincter (UOS) minimal diameters were measured by Endolumenal Functional Lumen Imaging Probe (EndoFLIP). HRM detected rapid pressure changes at the level of the 4th – 6th cervical vertebra. CPP, relative intensity, and ΔP were significant predictors of satisfactory TE phonation. ΔP was a significant predictor of CPP and intensity. Minimal UOS diameter was a significant predictor of relative intensity of TE phonation. In two patients with unsuccessful TE phonation, endoscopic dilatation subsequently restored TE phonation. These findings suggest that sufficient ΔP and large UOS diameter are required for satisfactory TE phonation. Endoscopic dilatation increasing UOS diameter may provide a new approach to treat unsuccessful TE phonation.

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Neoglottic Activity in Tracheoesophageal Phonation

Cited by 22 publications

References 9 publications

An Investigation of the Post-laryngectomy Swallow Using Videofluoroscopy and Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

An Investigation of the Post-laryngectomy Swallow Using Videofluoroscopy and Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Videostroboscopic Evaluation of Neoglottis in Alaryngeal Patients after Tracheoesophageal Voice Reconstruction without Prosthesis

The relationship between biomechanics of pharyngoesophageal segment and tracheoesophageal phonation

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