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Related Experiment Videos

Radiological assessment of post laryngectomy speech.

J McIvor1, P F Evans, A Perry

  • 1Department of Radiology, Charing Cross Hospital, London.

Clinical Radiology
|May 1, 1990
PubMed
Summary

Laryngectomy patients often struggle with alaryngeal speech. A new radiological technique identified a key pharyngeal segment (P-E segment) linked to effective speech, enabling targeted treatment for improved outcomes.

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Area of Science:

  • Otolaryngology
  • Radiology
  • Speech Pathology

Background:

  • Laryngectomy for laryngeal cancer has high survival rates but often results in poor alaryngeal speech.
  • Existing literature suggests speech difficulties stem from anatomical, physiological, psychological, sociological, or educational factors.

Purpose of the Study:

  • To develop and validate a radiological technique for assessing the reconstructed pharynx in post-laryngectomy patients.
  • To correlate specific pharyngeal anatomical and functional characteristics with alaryngeal speech effectiveness.

Main Methods:

  • A novel radiological technique combining video-fluoroscopy and static films was employed.
  • The pharyngeal anatomy and function were assessed during swallowing, attempted phonation, and air insufflation in 158 post-laryngectomy patients (24 good speakers, 134 poor/failed speakers).

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Main Results:

  • A single vibrating segment (P-E segment) was consistently observed in all good alaryngeal speakers.
  • Poor or failed speakers lacked this P-E segment and were classified into hypotonic, hypertonic, spastic, or strictured pharyngeal types based on radiological findings.
  • Subsequent clinical management based on this classification resulted in 84% of treated patients developing effective alaryngeal speech.

Conclusions:

  • The presence of a P-E segment is crucial for effective alaryngeal speech post-laryngectomy.
  • Radiological assessment of pharyngeal function provides a basis for targeted clinical management.
  • This classification system aids in improving speech outcomes for patients after laryngectomy.