Sound spectrogram analysis in patients receiving Kawahara’s surgical voice restoration for advanced carcinoma of the hypopharynx and cervical esophagus

Abstract

Loss of voice after total laryngectomy is a major concern that has prompted much effort to develop methods of surgical voice restoration. In 1992, Kawahara described a tracheocolic shunt for voice restoration using a revascularized ileocolic graft. With this method, aspiration through the phonatory shunt is prevented by the ileocolic valve (Bauhin's valve), while vocalization is allowed. The purpose of this study was to use sound spectrogram analysis to evaluate voices surgically restored in that way. Between 2002 and 2005, 10 consecutive patients underwent laryngopharyngoesophagectomy with Kawahara's surgical voice restoration for advanced carcinoma of the hypopharynx and/or cervical esophagus at Akita University Hospital, Japan. We then used sound spectrography to analyze and compare the voices of patients receiving Kawahara's voice restoration, against healthy volunteers and patients who underwent the same surgery without voice restoration and spoke using an electronic larynx. We also evaluated the intelligibility of conversation and performed a listening test. The sound spectrograms showed that when produced by the electronic larynx, consonant sounds and voice frequencies below 300 Hz were not clearly recognized. By contrast, in patients who received Kawahara's surgical voice restoration, consonant and vowel sounds at frequencies above and below 300 Hz were clearly recognized. Although conversation was intelligible with both Kawahara's surgical voice restoration and the electronic device, listeners judged the voice produced by the former to be superior. Thus, the voice produced by Kawahara's surgical voice restoration is superior to that produced by the electronic larynx.

Perceptual Evaluation and Acoustic Analysis of Pneumatic Artificial Larynx

“…Motoyama et al 20 reported that for those using the electronic larynx, consonant sounds and voice frequencies below 300 Hz were not clearly recognized in the sound spectrograms. The spectrographs in our study showed that the PAL was able to produce clear consonant and vowel sounds over a wide range of high and low frequencies.…”

The Method to Obtain the Rise and Fall of Anxiety, Estrogen, Progesterone and EEG Signals and Their Coincident Frequencies

“…In other words, it renders a map of frequency against time, where the time on which a particular component rise or fall in the signal can be found. These maps of frequency against time are called spectrograms and they have been widely used in many scientific areas (for examples see Hadjidimitriou & Hadjileontiadis, 2012;Motoyama et al, 2007;Sussillo, Kundaje, & Anastassiou, 2004;Roy, Montrsor, Abraham, & Saumet, 1999;Wollemann & Olaszy, 1977). According to Equation (2), the discrete time dependence of a spectrogram can be obtained by computing the Fourier transforms of the functions…”

Voice Reconstruction with Free Ileocolon Flap Transfer: Implications for the Lower Respiratory Tract

“…[2][3][4][5] However, none of these addressed specifically the occurrence of lower respiratory tract symptoms and pulmonary complications associated with this technique. The purpose of the present study was to investigate the prevalence of lower respiratory tract morbidity in patients undergoing reconstruction of the hypopharynx with a free ileocolon flap and to study the modifications, if any, of the bacterial flora of the patients at the tracheostomy site following flap transfer.…”