Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy
The study aimed to identify objective predictors of the successful voice rehabilitation after total laryngectomy to select the optimal method of voice restoration.Material and Methods. The study included 60 laryngectomized male patients who were stratified into 2 equal groups depending on the patien...
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| Language: | Russian |
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Russian Academy of Sciences, Tomsk National Research Medical Center
2024-01-01
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| Series: | Сибирский онкологический журнал |
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| Online Access: | https://www.siboncoj.ru/jour/article/view/2835 |
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| author | N. A. Daikhes S. S. Reshulskiy M. L. Isaeva V. V. Vinogradov |
| author_facet | N. A. Daikhes S. S. Reshulskiy M. L. Isaeva V. V. Vinogradov |
| author_sort | N. A. Daikhes |
| collection | DOAJ |
| description | The study aimed to identify objective predictors of the successful voice rehabilitation after total laryngectomy to select the optimal method of voice restoration.Material and Methods. The study included 60 laryngectomized male patients who were stratified into 2 equal groups depending on the patient’s choice of voice restoration: tracheoesophageal puncture or esophageal voice. A comprehensive assessment of the qualitative and quantitative parameters of the pharyngoesophageal segment was carried out using the diagnostic procedures, such as: fiberoptic endoscopic evaluation of swallowing, high-speed video endoscopy, and high-resolution pharyngoesophageal manometry. The results of examination of the pharyngoesophageal segment were compared with the results of voice rehabilitation.Results. A significant difference in the resting pressure in the pharyngoesophageal segment between patients with successful and unsuccessful voice rehabilitation was found. The resting pressure in the pharyngoesophageal segment was higher in patients with unsuccessful voice rehabilitation than in patients with successful voice rehabilitation. Among patients with failed voice rehabilitation, 64 % had pseudodiverticula, 25 % had cicatricial strictures and 11 % had pharyngospasm. Pseudodiverticula were found only in patients who underwent vertical or apparatus pharyngeal closure. We described vibrating patterns of substitute phonation in laryngectomized patients and identified 5 different types of pseudoglottis. No significant differences between the methods of substitute phonation were found.Conclusion. The state of pharyngoesophageal segment is an objective predictor of successful substitute phonation and depends on the surgical technique of pharyngeal closure, the volume of cancer treatment and the course of the postoperative period. A comprehensive assessment of the qualitative and quantitative parameters of the pharyngoesophageal segment using fiberendoscopic, fuoroscopic studies and highresolution pharyngoesophageal manometry allows prediction of voice rehabilitation outcomes. |
| format | Article |
| id | doaj-art-fb958481f79d4cc299a8f36e332808c1 |
| institution | Kabale University |
| issn | 1814-4861 2312-3168 |
| language | Russian |
| publishDate | 2024-01-01 |
| publisher | Russian Academy of Sciences, Tomsk National Research Medical Center |
| record_format | Article |
| series | Сибирский онкологический журнал |
| spelling | doaj-art-fb958481f79d4cc299a8f36e332808c12025-08-20T03:43:40ZrusRussian Academy of Sciences, Tomsk National Research Medical CenterСибирский онкологический журнал1814-48612312-31682024-01-01226556310.21294/1814-4861-2023-22-6-55-631183Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomyN. A. Daikhes0S. S. Reshulskiy1M. L. Isaeva2V. V. Vinogradov3National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia; N.I. Pirogov Russian National Research Medical University of the Ministry of Health of RussiaNational Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia; N.I. Pirogov Russian National Research Medical University of the Ministry of Health of RussiaNational Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of RussiaNational Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia; N.I. Pirogov Russian National Research Medical University of the Ministry of Health of RussiaThe study aimed to identify objective predictors of the successful voice rehabilitation after total laryngectomy to select the optimal method of voice restoration.Material and Methods. The study included 60 laryngectomized male patients who were stratified into 2 equal groups depending on the patient’s choice of voice restoration: tracheoesophageal puncture or esophageal voice. A comprehensive assessment of the qualitative and quantitative parameters of the pharyngoesophageal segment was carried out using the diagnostic procedures, such as: fiberoptic endoscopic evaluation of swallowing, high-speed video endoscopy, and high-resolution pharyngoesophageal manometry. The results of examination of the pharyngoesophageal segment were compared with the results of voice rehabilitation.Results. A significant difference in the resting pressure in the pharyngoesophageal segment between patients with successful and unsuccessful voice rehabilitation was found. The resting pressure in the pharyngoesophageal segment was higher in patients with unsuccessful voice rehabilitation than in patients with successful voice rehabilitation. Among patients with failed voice rehabilitation, 64 % had pseudodiverticula, 25 % had cicatricial strictures and 11 % had pharyngospasm. Pseudodiverticula were found only in patients who underwent vertical or apparatus pharyngeal closure. We described vibrating patterns of substitute phonation in laryngectomized patients and identified 5 different types of pseudoglottis. No significant differences between the methods of substitute phonation were found.Conclusion. The state of pharyngoesophageal segment is an objective predictor of successful substitute phonation and depends on the surgical technique of pharyngeal closure, the volume of cancer treatment and the course of the postoperative period. A comprehensive assessment of the qualitative and quantitative parameters of the pharyngoesophageal segment using fiberendoscopic, fuoroscopic studies and highresolution pharyngoesophageal manometry allows prediction of voice rehabilitation outcomes.https://www.siboncoj.ru/jour/article/view/2835larynx cancertotal laryngecromyvoice rehabilitationesophageal voicetracheoesophageal voice |
| spellingShingle | N. A. Daikhes S. S. Reshulskiy M. L. Isaeva V. V. Vinogradov Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy Сибирский онкологический журнал larynx cancer total laryngecromy voice rehabilitation esophageal voice tracheoesophageal voice |
| title | Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy |
| title_full | Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy |
| title_fullStr | Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy |
| title_full_unstemmed | Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy |
| title_short | Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy |
| title_sort | objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy |
| topic | larynx cancer total laryngecromy voice rehabilitation esophageal voice tracheoesophageal voice |
| url | https://www.siboncoj.ru/jour/article/view/2835 |
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