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Quantitative videofluoroscopy: a new evaluation tool for tracheoesophageal voice production
C J van As1, B M Op de Coul, F J van den Hoogen
1Department of Otolaryngology-Head and Neck Surgery, The Netherlands Cancer Institute/ Antoni van Leeuwenhoek Hospita, Amsterdam, The Netherlands.
Objective:
To develop a quantitative videofluoroscopy protocol using well-defined visual parameters and quantitative measures for the evaluation of anatomical and morphologic characteristics of the neoglottis in relation to perceptual evaluation of tracheoesophageal voice quality.
Design:
A patient survey.
Setting:
The Netherlands Cancer Institute, Amsterdam.
Patients:
Thirty-nine individuals with laryngectomies, 30 with standard total laryngectomy and 9 with a partial or total pharynx reconstruction.
Interventions:
Videofluoroscopy, speech recordings.
Main Outcome Measures:
Well-defined visual parameters and quantitative measures based on videofluoroscopy images should improve the evaluation of neoglottic characteristics in relation to voice quality.
Results:
Quantitative measures were significantly related to visual assessment outcomes. Tonicity (P=.02) and presence of a neoglottic bar during phonation (P=.03) were significantly related to voice quality, as were several quantitative measures, especially the minimal distance between the neoglottic bar and anterior esophageal wall at rest (P<.001) and during phonation (P=.02), and the index for the relative increase of the maximal subneoglottic distance from rest to phonation (P=.01).
Conclusions:
This new quantitative videofluoroscopy protocol is a useful tool for the study of the anatomy and morphology of the neoglottis. With this protocol, characteristics relevant to tracheoesophageal voice quality can be defined. The quantitative measures are promising for a more standardized evaluation of the neoglottis in individuals who have undergone laryngectomy.