Laryngeal Resection Voice Multi-dimensional Measurement And Assessment

Objective:Laryngeal carcinoma is one of the most common malignant tumors of Head & Neck.Operation which will change the patients' voices is the main therapy way.The purpose of this study is to develop a standard multi-dimensional quantitative evaluation system by investigating the different voices after various partial laryngectomy in order to instruct the patients rehabilitation training and to improve their quality of life(QOL)after surgery.Methods:(1)The voice samples were collected from 60 patients who had taken partial laryngectomy and 60 subjects with normal voices.(2)Subjective aural perceptive evaluation: According to the G component of the GRBAS,voices were graded into 4 scales from 0 to 3,0 for normal,1 for slight dysphonia,2 for moderate and 3 for severe dysphonia.(3)Objective evaluation: All the voices were recorded on an Dr.Speech for Windows Soft-ware which also offers vocal analysis,EGG;aerodynamic and resonant measurements.(4)Statistical tests:SPSS 13.0 statistical software was adopted to analysis all of the datum in the study.Results:(1)The acoustic and EGG parameters of the normal men which measured on a sustained vowel/se/are significantly different with those measured on another sustained vowel /i/.Shimmer,NNE,HNR,SNR and CQP are higher while CQ is lower.The significant different parameters of the normal women are only HNR,SNR and CQP which are higher and CQ which is lower.(2)The parameters of frequency showed that women's are higher than men's.And the normal women's MPT is shorter than the normal men's.(3)dF0,FOSD,Jitter,Shimmer,HNR and SNR of acoustic analysis can better distinguish the adjacent levels of dysphonia evaluated by subjective aural perception than those of EGG..(4)â‘ Generally,all of the partial laryngectomy groups' parameters are poorer than the normal.â‘¡MPTs of the three groups(Extended partiallar yngectomy(EL),Vertical partial laryngectomy(VL)and Horizontal vertical partial laryngectomy (HVL))are shorter than the normal and Horizontal supraglottic partial laryngectomy (HL)groups while NNEs are higher,and Amp Tremors are only higher than the normal control.â‘¢FOTremor and CQP of VL and HVL are higher than the control.â‘£Compared the resonantfreq uency of the vowels/ae/in group HL and HVL with the normal,the former are significantly higher.Conclusions:(1)The vowel/ae/is more suitable to be used in the objective evaluation as it is more real and reliable than/i/.(2)There are sexual differences in the vocal measurements,so it's necessary to develop the evaluation system and analyze datum separately.(3)Acoustic analy sis is superior to the EGG on these approximate meaning parameters.(4)â‘ The vocal function after partial laryngectomy descends on different degrees depending on variable types.â‘¡HL resulted in the slight dysphonia and the glottis closed down best while HVL resulted in the severe dysphonia and had the poorest closedown of the glottis.â‘¢EL and VL have the moderate quality of voices,and the former is better.â‘£It should choose the rehabilitation way such as relax exercises,abdominal respiration training,Accent method,Push by hands and Pitch ascending training to improve the patients' dysphonia.