How does Cricotracheal Resection Affect the Female Voice?

Smith, Marshall E.; Roy, Nelson; Stoddard, Kelly; Barton, Michael E.

doi:10.1177/000348940811700202

Cited by 47 publications

(92 citation statements)

References 20 publications

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“…Only one study with 32 patients quantified voice outcome from good to poor (25). Patients, especially (young) female patients, can experience a deeper voice after surgery as a serious handicap (9,27). As shown in our current study, voice dysfunction is indeed an existing and a relevant problem, especially after LTR.…”

Section: Discussionmentioning

confidence: 50%

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

Timman¹,

Schoemaker²,

Li³

et al. 2018

Ann. Cardiothorac. Surg.

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Background: In this study we focus on functional outcomes after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis, with a specific interest in the impact of laryngeal involvement on postoperative outcome.Methods: All patients who underwent (laryngo)tracheal surgery for benign pathology between 1996 and 2017 in our centre were included in this retrospective study. Surgical outcomes were procedural success rate, and airway-and voice-related complications. Functional results were assessed using (standardized) questionnaires for quality of life, sensation of dyspnea, swallowing function, and voice perception.Results: Of 119 consecutive patients, 47 underwent laryngotracheal resection and reconstruction and 72 underwent segmental tracheal surgery (78% with an end-to-end tracheal anastomosis and 22% with a cricotracheal anastomosis). Overall success rate was 92% and was similar for all groups, with an overall significant improvement in quality of life when compared to the preoperative situation. However, after laryngotracheal surgery, airway-related complications were more common when compared to segmental resections with an end-to-end tracheal anastomosis (30% versus 7%, P=0.003). Additionally, early voice alterations without recurrent nerve palsy were reported twice as often (34% versus 16%, P=0.034) and voice quality experienced during follow-up was significantly worse when compared to segmental resections.Overall response rate to the questionnaires on functional outcome was 63%.Conclusions: (Laryngo)tracheal surgery is safe and beneficial, with significant functional improvement during mid-and long-term follow-up. However, laryngeal involvement is a predictor for increased surgical airway-related complications. Additionally, voice alterations without recurrent nerve palsy are far more common after laryngotracheal resection and are a serious handicap. This aspect is underexposed in current literature and deserves further attention during preoperative counseling and patient follow-up. However, the results on functional outcome of this current study should be interpreted with caution due to the somewhat low response rate of the questionnaires.

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Section: Discussionmentioning

confidence: 50%

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

Timman¹,

Schoemaker²,

Li³

et al. 2018

Ann. Cardiothorac. Surg.

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“…Indeed these inherently biomechanical variations of vocal fold tissues might facilitate the transfer of energy from the subglottal airflow to the mucosal wave. 26,44,45 One finding (Fig. 4) that differs from Goodyer et al 26 is that the variations of mass and stiffness from inferior to superior along the vertical direction are not totally linear.…”

Section: Distribution Of Local Effective Mass and Stiffnessesmentioning

confidence: 83%

Three-dimensional biomechanical properties of human vocal folds: Parameter optimization of a numerical model to match in vitro dynamics

Yang

Berry

Döllinger

2012

The Journal of the Acoustical Society of America

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The human voice signal originates from the vibrations of the two vocal folds within the larynx. The interactions of several intrinsic laryngeal muscles adduct and shape the vocal folds to facilitate vibration in response to airflow. Three-dimensional vocal fold dynamics are extracted from in vitro hemilarynx experiments and fitted by a numerical three-dimensional-multi-mass-model (3DM) using an optimization procedure. In this work, the 3DM dynamics are optimized over 24 experimental data sets to estimate biomechanical vocal fold properties during phonation. Accuracy of the optimization is verified by low normalized error (0.13 6 0.02), high correlation (83% 6 2%), and reproducible subglottal pressure values. The optimized, 3DM parameters yielded biomechanical variations in tissue properties along the vocal fold surface, including variations in both the local mass and stiffness of vocal folds. That is, both mass and stiffness increased along the superior-to-inferior direction. These variations were statistically analyzed under different experimental conditions (e.g., an increase in tension as a function of vocal fold elongation and an increase in stiffness and a decrease in mass as a function of glottal airflow). The study showed that physiologically relevant vocal fold tissue properties, which cannot be directly measured during in vivo human phonation, can be captured using this 3D-modeling technique.

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“…Smith et al in a study of 14 females who underwent CTR found the fundamental frequency dropping by 21Herz (Hz) (p=0.03) in the post-operative period (12). However, the post-operative recordings were taken at different intervals (2.4-5.2 months) and the patients had a mixture of CTR techniques with varying degree of cricoid resection.…”

Section: Voicementioning

confidence: 98%

“…Common voice problems post-surgery include lower pitch, huskiness, difficulties with projection, vocal fatigue and inability to sing (10,12). Cricotracheal resection, in particular, is understood to alter female voices and can bring their vocal profile into a male range.…”

Section: Voicementioning

confidence: 99%

Voice and swallowing outcomes for adults undergoing reconstructive surgery for laryngotracheal stenosis

Clunie

Kinshuck

Sandhu

et al. 2017

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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How does Cricotracheal Resection Affect the Female Voice?

Cited by 47 publications

References 20 publications

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

Three-dimensional biomechanical properties of human vocal folds: Parameter optimization of a numerical model to match in vitro dynamics

Voice and swallowing outcomes for adults undergoing reconstructive surgery for laryngotracheal stenosis

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