Videokymographic analysis of patients after frontolateral laryngectomy with sternohyoid muscle flap reconstruction

A retrospective study was conducted to analyse videokymographic findings from patients who underwent vertical frontolateral laryngectomy with reconstruction using a sternohyoid muscle flap. Overall, 22 patients with T1b and T2 glottic tumours and more than one year of follow-up were studied. Two experienced observers analysed the recorded videokymographic data. A cross-sectional descriptive design was used. The images showed the vocal vibratory behaviour during sustained /i/ phonation. The vibratory source was supraglottic in 7/22 patients, glottic in 11 and mixed in 4. The mean duration of the glottic cycles extracted from the supraglottic, mixed and glottic vibratory sources was 6.4 ms, 5 ms and 4.6 ms, corresponding to the fundamental frequency (f0) of 188.7 Hz, 200 Hz and 215.7 Hz, respectively. Of the 11 patients with a glottic vibratory source, 4 did not present a closed phase in the glottic cycle. The mean open quotient was 79%, 40% and 63%, for the supraglottic, mixed and glottic vibratory sources, respectively. All 11 reconstructed vocal cords presented a rounded lateral peak. Of the 15 preserved vocal cords, 11 presented a rounded lateral peak and 4 had sharp peaks. All patients with a glottic vibratory source presented a rounded medial peak. All the vocal cords evaluated presented a mucosal wave, which was normal in 3 patients with a glottic source and clearly reduced in the others. Only one case presented phase asymmetry. The mean values for the amplitude asymmetry index were 0.92 and 0.68, for the mixed and supraglottic vibratory sources, respectively.