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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2018; 22(03): 303-312
DOI: 10.1055/s-0038-1625980
Original Research
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Supracricoid Laryngectomy: The Function of the Remaining Arytenoid in Voice and Swallowing

Elaine Cristina Pires Buzaneli
1   Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
,
Marcia Simões Zenari
2   Department of Reabilitation, Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
,
Marco Aurélio Vamondes Kulcsar
3   Department of Head and Neck Surgery, Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
,
Rogerio A. Dedivitis
3   Department of Head and Neck Surgery, Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
,
Cláudio Roberto Cernea
3   Department of Head and Neck Surgery, Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
,
Kátia Nemr
1   Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
› Author Affiliations
Further Information

Publication History

08 August 2017

17 December 2017

Publication Date:
29 March 2018 (online)

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Abstract

Introduction Supracricoid laryngectomy still has selected indications; there are few studies in the literature, and the case series are limited, a fact that stimulates the development of new studies to further elucidate the structural and functional aspects of the procedure.

Objective To assess voice and deglutition parameters according to the number of preserved arytenoids.

Methods Eleven patients who underwent subtotal laryngectomy with cricohyoidoepiglottopexy were evaluated by laryngeal nasofibroscopy, videofluoroscopy, and auditory-perceptual, acoustic, and voice pleasantness analyses, after resuming oral feeding.

Results Functional abnormalities were detected in two out of the three patients who underwent arytenoidectomy, and in six patients from the remainder of the sample. Almost half of the sample presented silent laryngeal penetration and/or vallecular/hypopharyngeal stasis on the videofluoroscopy. The mean voice analysis scores indicated moderate vocal deviation, roughness and breathiness; severe strain and loudness deviation; shorter maximum phonation time; the presence of noise; and high third and fourth formant values. The voices were rated as unpleasant. There was no difference in the number and functionality of the remaining arytenoids as prognostic factors for deglutition; however, in the qualitative analysis, favorable voice and deglutition outcomes were more common among patients who did not undergo arytenoidectomy and had normal functional conditions.

Conclusion The number and functionality of the preserved arytenoids were not found to be prognostic factors for favorable deglutition efficiency outcomes. However, the qualitative analysis showed that the preservation of both arytenoids and the absence of functional abnormalities were associated with more satisfactory voice and deglutition patterns.

Keywords

head and neck neoplasms - laryngectomy - voice - deglutition - speech therapy
 

  • References

  • 1 Piquet JJ, Desaulty A, Decroix G. Crico-hyoido-epiglotto-pexy. Surgical technic and functional results. Ann Otolaryngol Chir Cervicofac 1974; 91 (12) 681-686
    PubMedGoogle Scholar
  • 2 Pressman JJ. Submucosal compartmentation of the larynx. Ann Otol Rhinol Laryngol 1956; 65 (03) 766-771
    CrossrefPubMedGoogle Scholar
  • 3 Saito K, Araki K, Ogawa K, Shiotani A. Laryngeal function after supracricoid laryngectomy. Otolaryngol Head Neck Surg 2009; 140 (04) 487-492
    CrossrefPubMedGoogle Scholar
  • 4 Gonçalves AJ, Bertelli AA, Malavasi TR, Kikuchi W, Rodrigues AN, Menezes MB. Results after supracricoid horizontal partial laryngectomy. Auris Nasus Larynx 2010; 37 (01) 84-88
    CrossrefPubMedGoogle Scholar
  • 5 Nakayama M, Miyamoto S, Seino Y, Okamoto T, Kano K. Neoglottal revisions after supracricoid laryngectomy with cricohyoidoepiglottopexy. Jpn J Clin Oncol 2016; 46 (07) 642-645
    CrossrefPubMedGoogle Scholar
  • 6 Schindler A, Pizzorni N, Mozzanica F. , et al. Functional outcomes after supracricoid laryngectomy: what do we not know and what do we need to know?. Eur Arch Otorhinolaryngol 2016; 273 (11) 3459-3475
    CrossrefPubMedGoogle Scholar
  • 7 Fouquet ML, Vieira TPG, Murata CJM, Gonçalves AJ. Efeito imediato da técnica de firmeza glótica nas laringectomias parciais horizontais supracricoides: estudo inicial. Rev Soc Bras Fonoaudiol 2012; 17 (03) 346-350
    CrossrefGoogle Scholar
  • 8 Kruk-Zagajewska A, Szmeja Z, Szyfter W, Wójtowicz J, Citowicki W, Wierzbicka M. [Swallowing disorders in patients after the laryngeal cancer surgery]. Otolaryngol Pol 1995; 49 (01) 15-22
    PubMedGoogle Scholar
  • 9 Lewin JS, Hutcheson KA, Barringer DA. , et al. Functional analysis of swallowing outcomes after supracricoid partial laryngectomy. Head Neck 2008; 30 (05) 559-566
    CrossrefPubMedGoogle Scholar
  • 10 Naudo P, Laccourreye O, Weinstein G, Jouffre V, Laccourreye H, Brasnu D. Complications and functional outcome after supracricoid partial laryngectomy with cricohyoidoepiglottopexy. Otolaryngol Head Neck Surg 1998; 118 (01) 124-129
    CrossrefPubMedGoogle Scholar
  • 11 Nemr NK, Carvalho MB, Kohle J, Leite GCAL, Rapoport A, Szeliga RMS. Estudo funcional da voz e da deglutição na laringectomia supracricóide. Rev Bras Otorrinolaringol 2007; 73 (02) 151-155
    CrossrefGoogle Scholar
  • 12 So YK, Yun YS, Baek CH, Jeong HS, Son YI. Speech outcome of supracricoid partial laryngectomy: comparison with total laryngectomy and anatomic considerations. Otolaryngol Head Neck Surg 2009; 141 (06) 770-775
    CrossrefPubMedGoogle Scholar
  • 13 Allegra E, Lombardo N, La Boria A. , et al. Quality of voice evaluation in patients treated by supracricoid laryngectomy and modified supracricoid laryngectomy. Otolaryngol Head Neck Surg 2011; 145 (05) 789-795
    CrossrefPubMedGoogle Scholar
  • 14 Behlau M. Consensus Auditory- Perceptual Evaluation of Voice (CAPE-V), ASHA 2004. Refletindo sobre o novo/New reflexions. Rev Soc Bras Fonoaudiol 2004; 9 (03) 187-189
    Google Scholar
  • 15 Logemann JA. Evaluation and treatment of swallowing disorders. 2nd ed. Texas: Pro ED; 1998
    Google Scholar
  • 16 Sundberg J. Ciência da voz: fatos sobre a voz na fala e no canto. Trad. Salomão GL. São Paulo: Editora da Universidade de São Paulo; 2015
    Google Scholar
  • 17 Yamasaki R, Madazio G, Leão SHS, Padovani M, Azevedo R, Behlau M. Auditory-perceptual evaluation of normal and dysphonic voices using the voice deviation scale. J Voice 2017; 31 (01) 67-71
    CrossrefPubMedGoogle Scholar
  • 18 American Speech-Language Hearing Association National Outcome Measurement System (NOMS). Adults speech-language pathology training manual. Rockville, Md: American Speech-Language Hearing Association; 1998
    Google Scholar
  • 19 Marioni G, Marchese-Ragona R, Ottaviano G, Staffieri A. Supracricoid laryngectomy: is it time to define guidelines to evaluate functional results? a review. Am J Otolaryngol 2004; 25 (02) 98-104
    CrossrefPubMedGoogle Scholar
  • 20 Prado PRP, Dias FL, Santos IC, Freitas E, Ferreira LP. Avaliação videofluoroscópica no pós-operatório tardio de pacientes submetidos à laringectomia supracricoidea com cricohioidoepiglotopexia. Rev Bras Cir Cabeça Pescoço 2012; 41 (03) 124-127
    Google Scholar
  • 21 Ozturk K, Akyildiz S, Gode S. , et al. Post-surgical and oncologic outcomes of supracricoid partial laryngectomy: a single-institution report of ninety cases. ORL J Otorhinolaryngol Relat Spec 2016; 78 (02) 86-93
    CrossrefPubMedGoogle Scholar
  • 22 Torrejano G, Guimarães I. Voice quality after supracricoid laryngectomy and total laryngectomy with insertion of voice prosthesis. J Voice 2009; 23 (02) 240-246
    CrossrefPubMedGoogle Scholar
  • 23 Crosetti E, Garofalo P, Bosio C. , et al. How the operated larynx ages. Acta Otorhinolaryngol Ital 2014; 34 (01) 19-28
    PubMedGoogle Scholar
  • 24 Dworkin JP, Meleca RJ, Zacharek MA. , et al. Voice and deglutition functions after the supracricoid and total laryngectomy procedures for advanced stage laryngeal carcinoma. Otolaryngol Head Neck Surg 2003; 129 (04) 311-320
    CrossrefPubMedGoogle Scholar
  • 25 Makeieff M, Giovanni A, Guerrier B. Laryngostroboscopic evaluation after supracricoid partial laryngectomy. J Voice 2007; 21 (04) 508-515
    CrossrefPubMedGoogle Scholar
  • 26 Park JO, Joo YH, Cho KJ, Kim NG, Kim MS. Functional and oncologic results of extended supracricoid partial laryngectomy. Arch Otolaryngol Head Neck Surg 2011; 137 (11) 1124-1129
    CrossrefPubMedGoogle Scholar
  • 27 Zacharek MA, Pasha R, Meleca RJ. , et al. Functional outcomes after supracricoid laryngectomy. Laryngoscope 2001; 111 (09) 1558-1564
    CrossrefPubMedGoogle Scholar
  • 28 Schindler A, Favero E, Nudo S, Albera R, Schindler O, Cavalot AL. Long-term voice and swallowing modifications after supracricoid laryngectomy: objective, subjective, and self-assessment data. Am J Otolaryngol 2006; 27 (06) 378-383
    CrossrefPubMedGoogle Scholar
  • 29 Bron L, Pasche P, Brossard E, Monnier P, Schweizer V. Functional analysis after supracricoid partial laryngectomy with cricohyoidoepiglottopexy. Laryngoscope 2002; 112 (7 Pt 1): 1289-1293
    CrossrefPubMedGoogle Scholar
  • 30 Nemr K, Simões-Zenari M, Cordeiro GF. , et al. GRBAS and Cape-V scales: high reliability and consensus when applied at different times. J Voice 2012; 26 (06) 812.e17-812.e22
    CrossrefPubMedGoogle Scholar
  • 31 Portas JG, Queija DdosS, Arine LP. , et al. Voice and swallowing disorders: functional results and quality of life following supracricoid laryngectomy with cricohyoidoepiglottopexy. Ear Nose Throat J 2009; 88 (10) E23-E30
    PubMedGoogle Scholar
  • 32 Svicero MAF. Caracterização acústica e de imagens de ultrassonografia das vogais orais do Português Brasileiro [dissertação]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2012
    Google Scholar
  • 33 Timon CI, Hirani SP, Epstein R, Rafferty MA. Investigation of the impact of thyroid surgery on vocal tract steadiness. J Voice 2010; 24 (05) 610-613
    CrossrefPubMedGoogle Scholar