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Vocal function following hemilaryngectomy.

M Hirano1, S Kurita, H Matsuoka

  • 1Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Japan.

The Annals of Otology, Rhinology, and Laryngology
|September 1, 1987
PubMed
Summary

This study examined vocal function after hemilaryngectomy using sternohyoid muscle flaps for reconstruction. Lip mucosa covering yielded better vocal outcomes compared to skin flaps.

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Area of Science:

  • Otolaryngology
  • Speech-Language Pathology
  • Surgical Reconstruction

Background:

  • Hemilaryngectomy is a surgical procedure for laryngeal cancer.
  • Glottic reconstruction is crucial for restoring vocal function post-surgery.
  • Sternohyoid muscle flaps are utilized for this reconstruction.

Purpose of the Study:

  • To evaluate vocal function after hemilaryngectomy with sternohyoid muscle flap reconstruction.
  • To compare the efficacy of different flap covering materials on voice quality.

Main Methods:

  • Retrospective analysis of 54 hemilaryngectomy cases.
  • Use of superiorly based sternohyoid muscle flap for glottic reconstruction.
  • Comparison of four flap covering materials: hypopharyngeal mucosa, lip mucosa, thyroid perichondrium, and island cervical skin flap.

Main Results:

  • Vocal function varied significantly among patients.
  • Common findings included incomplete glottic closure, supraglottic hyperfunction, irregular laryngeal vibrations, reduced phonation time, increased airflow rate, and limited pitch/loudness range.
  • Voice quality was often rough, breathy, or strained.
  • Poorest vocal function was observed with skin flaps, while lip mucosa resulted in the best outcomes.

Conclusions:

  • The choice of covering material for sternohyoid muscle flaps significantly impacts vocal outcomes after hemilaryngectomy.
  • Lip mucosa appears to be a superior option for glottic reconstruction compared to skin flaps.
  • Further research into optimizing flap materials and techniques is warranted to improve voice quality post-laryngectomy.

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