Voice and communication after open partial horizontal laryngectomies: A cross‐sectional outcome study

Abstract

Objective: The present study evaluates voice and communication after open partial horizontal laryngectomies (OPHLs), according to surgery and patientrelated variables. Methods: Fifty-eight patients were included: 18 type I OPHL, 20 type II OPHL and 20 type III OPHL. Acoustic, aerodynamic, endoscopic, perceptual and selfassessment analyses were carried out. Surgery-related variables and patientrelated variables were considered for the analysis.Results: Type I OPHL revealed the best phonatory outcomes. Type II and type III OPHL showed similar and poor results, with a highly deteriorated voice quality. A significant difference in MTP was found for patients who had both arytenoids/cricoarytenoid units preserved. Age and time from surgery showed significant correlations with voice quality after OPHLs.Conclusions: Voice and communication outcomes after OPHLs are heterogeneous and might be influenced by several factors. Knowing variables with a substantial impact on phonatory outcomes may help clinicians in the preoperative decision-making process and the postoperative rehabilitative program.

Current Status of Partial Laryngeal Surgery for Advanced Laryngeal Cancer: When and Why?

“…Moreover, these procedures are designed to conserve the primary functions of the larynx (swallowing, breathing, and phonation) while aiming to obviate the necessity for a permanent tracheostomy. Reports indicate 5-year laryngeal function preservation (LFP) rates post–OPHL ranging from 91.2% to 98.5% according to the primary extent of the disease, with comparable functional outcomes observed between type II and type III OPHLs [ 32 ••, 36 ••, 49 ]. Despite these promising figures, the incidence of acute complications and late sequelae, potentially necessitating total laryngectomy or permanent gastrostomy, underscores the significance of surgical expertise and patient-specific considerations.…”

Subjective Perception and Psychoacoustic Aspects of the Laryngectomee Voice: The Impact on Quality of Life

“…Each parameter is scored on a visual analogue scale from 0 (minimally deviant) to 10 (maximally deviant substitution voicing). This validated auditory-perceptual scale, the reliability of which has also been proven in native Italian-speaking patients [ 12 , 13 , 14 , 15 , 16 ], seems to overwhelm the limits of the previously proposed GRBAS perceptual rating scale (grade, roughness, breathiness, asthenia, strain, on a scale of 0–3, where 0 = normal, 1 = mild degree, 2 = moderate degree and 3 = high degree) [ 17 ]. Even if the GRBAS scale presented a positive correlation with acoustic, aerodynamic and voice-related quality of life questionnaires [ 18 , 19 , 20 ], it does not seem to be the best tool for evaluating substitution voices.…”