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Quantitative Videofluoroscopy
A New Evaluation Tool for Tracheoesophageal Voice Production
Corina J. van As, MSc;
Bas M. R. Op de Coul, MD;
Frank J. A. van den Hoogen, MD, PhD;
Florien J. Koopmans–van Beinum, PhD;
Frans J. M. Hilgers, MD, PhD
Arch Otolaryngol Head Neck Surg. 2001;127:161-169.
Objective To develop a quantitative videofluoroscopy protocol using well-defined
visual parameters and quantitative measures for the evaluation of anatomical
and morphologic characteristics of the neoglottis in relation to perceptual
evaluation of tracheoesophageal voice quality.
Design A patient survey.
Setting The Netherlands Cancer Institute, Amsterdam.
Patients Thirty-nine individuals with laryngectomies, 30 with standard total
laryngectomy and 9 with a partial or total pharynx reconstruction.
Interventions Videofluoroscopy, speech recordings.
Main Outcome Measures Well-defined visual parameters and quantitative measures based on videofluoroscopy
images should improve the evaluation of neoglottic characteristics in relation
to voice quality.
Results Quantitative measures were significantly related to visual assessment
outcomes. Tonicity (P=.02) and presence of a neoglottic
bar during phonation (P=.03) were significantly related
to voice quality, as were several quantitative measures, especially the minimal
distance between the neoglottic bar and anterior esophageal wall at rest (P<.001) and during phonation (P=.02),
and the index for the relative increase of the maximal subneoglottic distance
from rest to phonation (P=.01).
Conclusions This new quantitative videofluoroscopy protocol is a useful tool for
the study of the anatomy and morphology of the neoglottis. With this protocol,
characteristics relevant to tracheoesophageal voice quality can be defined.
The quantitative measures are promising for a more standardized evaluation
of the neoglottis in individuals who have undergone laryngectomy.
From the Department of Otolaryngology–Head and Neck Surgery,
the Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam
(Drs van As and Hilgers), Institute of Phonetic Sciences, University of Amsterdam,
Amsterdam (Drs van As and Koopmans–van Beinum), and Department of Otolaryngology/Head
and Neck Surgery, University Hospital St Radboud, Nijmegen (Drs Op de Coul
and van den Hoogen), the Netherlands.
Corresponding author and reprints: Frans J. M. Hilgers, MD, PhD,
Department of Otolaryngology-Head and Neck Surgery, The Netherlands Cancer
Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands (e-mail: fhilg{at}nki.nl).
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