Evaluation of voice and speech following subtotal reconstructive laryngectomy

Subtotal reconstructive laryngectomy (SRL) can be used to preserve voice in the treatment of selected laryngeal carcinomas. This study was designed to analyze both voice and speech results achieved after SRL in 14 male patients, aged from 48 to 73 years. Surgery was performed between 1983 and 1993. Fundamental frequencies, ranges of frequency, intensities, and intensity ranges were established using an S.I. 80 Philips AAC 600 Audio Active Comparative Language System. Five prolonged vowels and six phonetically balanced sentences were recorded on a tape positioned at a distance of 30 cm from the mouth of each patient during a 3-min recording time. The recorded material was then evaluated by a panel of ten trained listeners who were asked to consider the qualitative parameters and perceptual characteristics of voice and speech according to a scorecard modified from one devised by Voiers and Formigoni. Although a decrease was determined in Fundamental Frequency and intensity of the voice when compared to normal values, the quality and perception of speech were found to be satisfactory. The verbal message could be understood almost exactly by means of constant sonority, correct articulation and improved pneumophonic coordination. These values demonstrate that the new voice achieved after SRL is less sonorous and allows for understandable and socially acceptable speech.