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Neoglottic activity in tracheoesophageal phonation
M Mohri1, M Yoshifuji, M Kinishi
1Department of Otorhinolaryngology-Head and Neck Surgery, Kobe University School of Medicine, Japan.
Auris, Nasus, Larynx
|January 1, 1994
Summary
Tracheoesophageal (TE) phonation involves two stages: hypopharyngeal closure for preparation and vocal fold vibration for sound production. This clarifies the dynamics of voice restoration after laryngectomy.
Area of Science:
- Speech and Voice Science
- Otolaryngology
- Biomedical Engineering
Background:
- The retropharyngeal wall prominence is accepted as the vibratory source in alaryngeal phonation.
- The precise relationship between vocalization and the dynamics of this prominence is not fully understood.
Purpose of the Study:
- To elucidate the relationship between the vocalization process and the dynamics of the retropharyngeal prominence during tracheoesophageal (TE) phonation.
- To clarify the mechanism of voice restoration following total laryngectomy using TE phonation.
Main Methods:
- Electromyography (EMG), manometry, and fiberoptic observation of the hypopharynx were performed in 7 subjects undergoing TE phonation.
- Subjects had undergone TE fistulization as part of their total laryngectomy.
Main Results:
- Fiberscopy showed prephonatory closure of the hypopharyngeal lumen, creating a specific configuration for air escape and mucosal vibration.
- EMG revealed a distinct two-burst activity pattern with an intervening quiet period.
Conclusions:
- TE phonation is a two-step process: a preparatory stage involving hypopharyngeal closure and a phonatory stage with neoglottis vibration.
- Hypopharyngeal muscle contraction maintains the neoglottis configuration during the phonatory stage.