Voice rehabilitation with tragal cartilage and perichondrium after vertical partial laryngectomy for glottic cancer

Abstract

Background: The goal of the study is to test  medialization of the neocord after oncological surgery for glottic cancer, using autologous tragal cartilage and perichondrium by the direct approach. Materials and Methods: Sixteen patients underwent comprehensive assessment including auditory perceptual assessment, videostrobolaryngoscopy, and acoustic voice analysis. The cartilage graft was inserted into a pocket created in the tyroarytenoid — lateral cricoarytenoid muscle complex or the excavated musculomembranous part of the neocord, and fixed by placing the perichondrium by the direct approach. The patients were evaluated preoperatively, and at 14 days, 60 days, and 6 months later. Results: Improvement of voice and breathiness was correlated with the increase of closed quotient and harmonic-to-noise ratio; the acoustic voice parameters studied showed significant differences between preoperative and postoperative voices, and these objective measurements of voice changes provided accurate and documentary evidence of the results of surgical treatment. Conclusion: This method may be considered a safe and efficient phonosurgical procedure for voice restoration.

Key words: Cartilage, glottic cancer, medialization, partial laryngectomy, perichodrium, voice restoration