Analysis of Tracheoesophageal Voice after Total Laryngectomy: A Single Center Experience

Abstract

Background/Objectives: Tracheoesophageal voice is the most commonly used voice rehabilitation technique after a total laryngectomy. The placement of the tracheoesophageal prosthesis can be performed at the same time as the total laryngectomy (primary placement) or in a second procedure after surgery (secondary placement). The purpose of this study is to analyze the substitution voice in patients with a tracheoesophageal prosthesis, considering the influence of radiotherapy and timing of prosthesis placement (primary or secondary) on voice quality. Methods: A retrospective analysis was conducted of all patients who received a tracheoesophageal phonatory prosthesis after a total laryngectomy was performed. We assessed whether patients received radiotherapy and whether they had a primary or secondary tracheoesophageal prosthesis. For the voice analysis, maximum phonation time (MPT), INFVo, SECEL, AVQI, CPPS, harmonic to noise ratio (HNR), unvoiced fraction (UVF), and number of voice breaks (NVB) were evaluated. Results: A total of 15 patients (14 males and 1 female) with a mean age of 71.8 years (SD ± 7.5) were enrolled. Eight had a primary prosthesis placement and five did not receive radiotherapy. INFVo parameters I and Vo were higher in patients with a primary placement of the phonatory prosthesis (p = 0.046 and p = 0.047). Patients who received the prosthesis secondarily had a higher mean CPPS and lower mean AVQI. Conclusions: A secondary placement of the prostheses seems to result in a minimal advantage in voice quality compared to a primary placement. Radiation therapy, on the other hand, has no effect on voice quality, according to these preliminary data.