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KMID : 0361020000430090978
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Korean Journal of Otolaryngology - Head and Neck Surgery
2000 Volume.43 No. 9 p.978 ~ p.984
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Imaging and Acoustic Study of Laryngectomees after the Amatsu Tracheoesophageal Shunt Operation
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Lee Han-Kook
Lee Kang-Dae
Lee Yun-Woo
Lee Bong-Hee
Kim Sun-Gon
Joo Ho-Bum
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Abstract
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Background and Objectives: The two most important methods for voice rehabilitation after total laryngectomy are tracheoesophageal speech. The former can be obtained in several ways, for example by the primary Amatsu tracheoesophageal (T-E) shunt operation or by the use of a low-resistance valve such as the Provox prosthesis. The purpose of this investigation was to study the anatomy and physiology of the neoglottis and to evaluate the vocal quality of tracheoesophageal speech.
Materials and Methods: A total of 12 patients, who had undergone the Amatsu T-E shunt operation after total laryngectomy, were analyzed using the stroboscopy, laryngofiberscopy, videofluoroscopy, and computerized speech lab.
Results: With stroboscopy, the neoglottis was spilt from left to right in 3 patients and in 9 patients, the direction of opening and closure of the neoglottis was anterior-posterior. The regular vibratory features were observed in patients with a shortened visible vibratory segment. The results of videofluoroscopy indicate that the location of the vibration was mostly situated between C3 and C5. The cervical esophagus closure during tracheoesophageal phonation was located at a level between C7-T2.
Conclusion: The anatomical and morphological characteristics of the neoglottis was related to the healing process after operation. The neoglottis was considered to be formed by the thyropharyngeal muscle, and concentric contraction under subneoglottic extension was formed was formed by the contraction of the cervical esophagus.
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KEYWORD
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Layngectomy, Tracheoesophageal, Voice rehabilitation
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