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Assessment of Irregular Voices After Total and Laser Surgical Partial Laryngectomy
Arno Olthoff, MD;
Sibylle Mrugalla, MD;
Rainer Laskawi, MD;
Matthias Fröhlich, PhD;
Ingo Stuermer, PhD;
Eberhard Kruse, MD;
Petra Ambrosch, MD;
Wolfgang Steiner, MD
Arch Otolaryngol Head Neck Surg. 2003;129:994-999.
Objectives To assess the merits of computer-aided voice analysis procedures for very irregular voices of patients after total and laser surgical partial laryngectomy, and to characterize qualitative differences in speech and voice function between these 2 groups of patients.
Design Cross-sectional study.
Setting University hospital in Göttingen, Germany.
Patients Twenty-nine patients with advanced laryngeal carcinomas (T3-T4; according to the Union Internationale Contre le Cancer, TNM staging system, stages III-IVa) were examined: 18 patients with tracheoesophageal speech (voice prosthesis) after total laryngectomy and 11 patients who underwent partial transoral resection of the larynx (by means of laser microsurgery without surgical voice rehabilitation).
Main Outcome Measures Speech intelligibility was measured by a standardized and validated telephone test, and voice quality was determined by 2 computerized voice analysis systems (multidimensional voice program and Göttingen hoarseness diagram).
Results The telephone test demonstrated a significantly better speech performance of the patients who had undergone organ-preserving surgery. The voices of both patient groups were too irregular for a qualitative differentiation with the multidimensional voice program. The multidimensional voice program results also failed to show significant correlations to speech intelligibility. The Göttingen hoarseness diagram showed significantly more regular voices in patients with partial laryngectomy than total laryngectomy. These results were correlated with speech intelligibility.
Conclusions The Göttingen hoarseness diagram is suitable for a qualitative assessment even of irregular voices. Voice prosthesis offers a voice quality that at best approaches that of patients with partial laryngectomy.
From the Departments of Phoniatrics and Pedaudiology (Drs Olthoff and Kruse) and Otorhinolaryngology (Drs Mrugalla, Laskawi, Ambrosch, and Steiner), Drittes Physikalisches Institut (Dr Fröhlich), and Sensory Developmental and Voice Research, Department of Phoniatrics and Pedaudiology (Dr Stuermer), University of Göttingen, Göttingen, Germany. The authors have no relevant financial interest in this article.
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