Evaluation of dysphonia in partial laryngectomy patients

Yıl 2006, Cilt: 16 Sayı: 2, 54 - 59, 20.03.2006

Tolga Kandoğan Aylin Şanal Gürol Gültekin Levent Olgun Uğur Çerçi

Öz

Objectives: The purpose of this study was to research and compare the affects of cordectomy, frontolateral laryngectomy or cricohyoidopexy tech- niques över voice parameters prospectively.Patients and Methods: Fifty six larynx cancer patients, 56 males; mean age 59; range 48 to 71 years whom cordectomy, frontolateral laryngectomy or cricohyoidopexy was applied in S.B. İzmir Training Hospital were included in this study. İn the subjective evaluation of the patients voices, RBH scoring, in the aerodynamic evaluation, MPT mea- surements and in the objective evaluation, comput- erized voice analysis was used. İn calculating the dysphonia severity index DSİ , this formula DSI=0.13xMPT+0.0053xF0 high -0.26xl low - 1.18x jitter % +12.4 was used.Results: İn the subjective RBH evaluation of voices of these three group of patients and their DSİ scores, there wasn’t any statistically differ- ences among them. When arytenoidectomized patients are evaluated as a separate group, this procedure is found not to have a significant impact över DSİ.Conclusion: From phoniatric point of view, there wasn’t any difference of cordectomy, frontolateral laryngectomy or cricohyoidopexy techniques över voice.

Anahtar Kelimeler

Cordectomy, frontolateral laryngectomy, cricohyoidopexy, DSİ, voice analysis

Parsiyel larenjektomili hastalarda disfoni değerlendirilmesi

Öz

Amaç: Kordektomi, frontolateral larenjektomi ve krikohyoidopeksi ameliyat tekniklerinin ses parametrelerine etkisi prospektif olarak araştırıldı ve karşılaştırıldı.Hastalar ve Yöntemler: Larenks kanseri nedeniyleS. B. İzmir Eğitim Hastanesi’nde kordektomi, frontolateral larenjektomi ve krikohyoidopeksi uygulanan, 56hasta incelemeye alındı. Hastaların seslerinin subjektif değerlendirilmesinde RBH skorlamasından, aerodinamik değerlendirmesinde maksimum fonasyon süresi MPT ölçümünden ve objektif değerlendirmesinde de bilgisayarlı ses analizinden yararlanıldı. Disfoni şiddetininhesaplanmasında DSI=0.13xMPT+0.0053xF0 high 0.26xI low -1.18x jitter % +12.4] 4 formülü kullanıldı. Bulgular: Hastaların seslerinin subjektif RBH değerlendirmesinde, gruplar arasında anlamlı bir fark saptanmadı. Disfoni şiddet endeksi DSI-dysphonia severityindex skorları arasında da anlamlı fark yoktu. Aritenoidektomi yapılanlar ayrı bir grup olarak incelendiğinde,aynı ameliyat uygulanan hastalar içerisinde aritenoidektominin DSI’yi artırıcı bir etkisinin olmadığı izlendi.Sonuç: Kordektomi, frontolateral larenjektomi ve krikohyoidopeksi ameliyatlarının sese olan etkilerininkarşılaştırmasında hiçbirinin foniatrik yönden diğerlerine üstün olmadığı kanısına varıldı

Anahtar Kelimeler

Kordektomi, frontolateral larenjektomi, krikohyoidopeksi, DSI, ses analizi

Kaynakça

• Nawka T, Anders LC, Wendler J. Die auditive Beurteilung heiserer Stimmen nach dem RBH-System. Sprache-Stimme-Gehör 1994;18:130-3.
• Wirth G. Stimmstörungen. 3rd ed. Koln: Deutscher Aerzte Verlag; 1991. p. 113, 236.
• Schutte HK, Seidner W. Recommendation by the Union of European Phoniatricians (UEP): standardiz- ing voice area measurement/phonetography. Folia Phoniatr (Basel) 1983;35:286-8.
• Wuyts FL, De Bodt MS, Molenberghs G, Remacle M, Heylen L, Millet B, et al. The dysphonia severity index: an objective measure of vocal quality based on a mul- tiparameter approach. J Speech Lang Hear Res 2000;43:796-809.
• Laccourreye H, Laccourreye O, Weinstein G, Menard M, Brasnu D. Supracricoid laryngectomy with crico- hyoidoepiglottopexy: a partial laryngeal procedure for glottic carcinoma. Ann Otol Rhinol Laryngol 1990;99(6 Pt 1):421-6.
• Laccourreye H, Lacau St Guily J, Brasnu D, Fabre A, Menard M. Supracricoid hemilaryngopharyngectomy. Analysis of 240 cases. Ann Otol Rhinol Laryngol 1987;96(2 Pt 1):217-21.
• Zacharek MA, Pasha R, Meleca RJ, Dworkin JP, Stachler RJ, Jacobs JR, Marks SC, Garfield I. Functional outcomes after supracricoid laryngectomy. Laryngoscope 2001;111:1558-64.
• Laccourreye O, Crevier-Buchmann L, Weinstein G, Biacabe B, Laccourreye H, Brasnu D, et al. Duration and frequency characteristics of speech and voice fol- lowing supracricoid partial laryngectomy. Ann Otol Rhinol Laryngol 1995;104:516-21.
• Piquet JJ, Chevalier D. Subtotal laryngectomy with crico-hyoido-epiglotto-pexy for the treatment of extended glottic carcinomas. Am J Surg 1991;162:357- 61.
• Laccourreye O, Brasnu D, Merite-Drancy A, Cauchois R, Chabardes E, Menard M, et al. Cricohyoidopexy in selected infrahyoid epiglottic carcinomas presenting with pathological preepiglottic space invasion. Arch Otolaryngol Head Neck Surg 1993;119:881-6.
• Pech A, Cannoni M, Giovanni A, Thomassin JM, Zanaret M, Goubert JL. [Requisite selection of surgical technics in the treatment of cancer of the larynx] Ann Otolaryngol Chir Cervicofac 1986;103:565-75.
• Chevalier D, Thill C, Darras JA, Piquet JJ. [Subtotal laryngectomy in the treatment of extensive tumors of the larynx] Ann Otolaryngol Chir Cervicofac 1991;108:378-81.
• Laccourreye H, Laccourreye O, Weinstein G, Menard M, Brasnu D. Supracricoid laryngectomy with crico- hyoidopexy: a partial laryngeal procedure for selected supraglottic and transglottic carcinomas. Laryngoscope 1990;100:735-41.
• Crevier-Buchman L, Laccourreye O, Weinstein G, Garcia D, Jouffre V, Brasnu D, et al. Evolution of speech and voice following supracricoid partial laryn- gectomy. J Laryngol Otol 1995;109:410-3.
• Laccourreye O, Weinstein G, Brasnu D, Bassot V, Cauchois R, Jouffre V, et al. A clinical trial of continu- ous cisplatin-fluorouracil induction chemotherapy and supracricoid partial laryngectomy for glottic carci- noma classified as T2. Cancer 1994;74:2781-90.