Vocal Function following Hemilaryngectomy

Abstract

Vocal function following hemilaryngectomy was investigated in 54 cases in which a superiorly based sternohyoid muscle flap was used for glottic reconstruction. Four types of material were employed for covering the muscle flap: hypopharyngeal mucosa, lip mucosa, thyroid perichondrium, and island cervical skin flap. The vocal function varied greatly from individual to individual; however, the following tendencies were observed in many cases: 1) the glottis did not close completely; 2) supraglottic structures (false fold, arytenoid region, and epiglottis) were hyperfunctional and vibrated instead of or together with the unaffected vocal fold; 3) vibrations of the laryngeal structures were irregular; 4) maximum phonation time was short; 5) mean airflow rate was high; 6) fundamental frequency and intensity ranges of phonation were limited; 7) the voice was rough, breathy, and/or strained; and 8) cases with poor vocal function were most frequent in the skin flap group and least frequent in the lip mucosa group.

Laryngeal reconstruction by platysma myofascial flap after vertical partial laryngectomy

“…The technique of glottic reconstruction must fulfill three criteria for satisfactory vocal function: adequate glottic closure during phonation, proper alignment of the neofold at the glottic level, and smooth lining for the reconstructed area. 17,18 The necessary properties of ideal tissue for glottic reconstruction have been emphasized in recent studies: the ideal tissue should have reliable blood supply, adequate soft tissue bulk, and viscoelasticity as similar as possible to the native laryngeal structure.…”

Análise funcional da laringe pós-cordectomia, reconstruída com retalho de prega vestibular

“…According to Hirano et al 17 , laryngeal closure is complete in hemilaryngectomies, reconstructed with different techniques. The author referred that during vibration cycles, there is complete closure only in 19% of the cases.…”

Pressure and velocity profiles in a static mechanical hemilarynx model

“…The pressures can be obtained for a wide range of glottal diameters and airflow rates; other glottal angles than the one used here can also be incorporated. Also, the mechanical model is similar to the human larynx for a hemilaryngectomy in that there is one relatively normal vocal fold that would vibrate against a reconstructed nonvibrating opposite side ͑Hirano et al., 1987;Leeper et al, 1990͒. A relatively direct application of the results of this model is in the consideration of dynamic hemilarynx models. For example, the studies using hemilarynx canine models ͑Jiang and Titze, 1993Titze, , 1994Alipour and Scherer, 2000; surface.…”

“…One can therefore crudely estimate the upstream peak velocity by dividing the Reynolds number by 1000. People with a hemilaryngectomy often have higher flow rates than those with normal larynges ͑Hirano et al., 1987;Leeper et al, 1990;Andrews et al, 1997͒. Thus, for example, if the Reynolds number in the trachea reaches 3000, the peak velocity may be approximately 3 m/s, approximately ten times less than expected peak glottal velocities ͓see Fig. 9͑c͔͒.…”