The voice of patients with laryngeal carcinoma after oncosurgery

Abstract

The voice of patients indicated for surgical procedures in treating of dysphonia is already damaged before the operation. The problem, which exists at the level of glottis patients usually try to solve by compensative mechanisms. The quality of voice after the interventions in larynx depends on the type and width of resection, disturbance of physiological phonation mechanisms, and ability to establish optimal phonation automatism. The damage of laryngeal structure, especially its glottic part and vocal cords as its central part, no matter if they are just fibrous or they are partially or totally absent, leads into the development of substitutive phonation mechanisms. The most frequent substitutive mechanisms are: vestibular, ventricular, and chordoventricular phonation. There are some variations of these phonation mechanisms, which are conditioned not only by applied surgical technique, but as they are also individual characteristics, they can be the consequence of applied rehabilitation methods. The diagnosis of voice condition before and after the oncosurgical procedure is done by: laryngostroboscopy, subjective acoustic analysis of voice, and objective acoustic analysis of voice (sonography or computer analysis of acoustic signal). The most of laryngeal carcinomas appear in glottic region, so the function of phonation imposes itself as the objective parameter to measure the quality of life after the oncosurgery of larynx. That is the reason why according to the priority, it is just behind the principle of "oncologic radicalism". Phonation as the most complex laryngeal function seems to have secondary importance. All known operative techniques, especially partial resections, have the preservation of phonation as their goal.