Project Details
Abstract
This 3-year-period proposal contains a series of further researches involving the
clinical and phonetic studies of three specific voice disorders. One of the disorders is
abnormally tight speech due to shunt stenosis in near-total laryngectomy. Abnormal shunt
speech may be due to stenosis of the speech shunt and granulation or fibrotic bands in the
shunt. The previous NSC study (Clinical and Phonetic Studies of specific voice
disorders–I) revealed that near-total laryngectomy patients with a normal, fluent shunt
speech presented their subglottic pressures (SP) ranged between 30 to 79 mmH2O. SP in
mildly stenotic speaking shunts ranged between 80 to 95 mmH2O, SP in moderately
stenotic shunts ranged between 96 to 110 mmH2O, and a severely stenotic shunt had the
SP above 111 mmH2O. This proposal includes 3 projects in a 3-year period.
The first-year study(Aug. 2007 ~ July 2008) will evaluate the effectiveness of
transoral laser and dilatation for a mild to moderate shunt stenosis (due to
granulation or fibrotic band in the shunt lumen) in near-total laryngectomy patients.
Pre- and post-operative voice assessments (GRBAS, patient self-rating, acoustic and
aerodynamic analyses) will be performed. The pre- and post-op subglottic pressures
during phonation will also be measured by using a microtip pressure sensor (Microtip
Transducer Catheter, ups-2020), via the permanent tracheostoma.Pre-&post-operative
3D imagings of the speech shunt will be carried out. The above parameters and the
surgical outcome will be analyzed and evaluated.
The second-year study (Aug. 2008 ~ July 2009) will focus on a new approach to
laser myoneurectomy of thyroarytenoid muscles on the spasmodic dysphonia
patients who had poorly responded to the traditional managements. The effectiveness of this surgical procedure will be evaluated based on analyses of the parameters of the preand
post-operative vocal function studies and videolaryngostroboscopy. To evaluate the
long-term outcome of this technique, a further 3-year follow up of these patients will be
performed.
The third-year study (Aug. 2009 ~ July 2010) will involve the development of
transoral laser surgery for the false cord bulging in glottal incompetent patients
who had undergone a strap muscle transposition laryngoplasty. The routine voice
assessments and video laryngeal stroboscopy will be carried out. The preoperative data
will be compared with those measured at 6 months or more after surgery and the efficacy
of this surgical technique will be evaluated.
To the best of our knowledge, the above three subjects in this proposal have not
been previously reported in the literature. The native data of these three issues are still
lacking.
Project IDs
Project ID:PC9609-3957
External Project ID:NSC96-2628-B182A-125-MY3
External Project ID:NSC96-2628-B182A-125-MY3
Status | Finished |
---|---|
Effective start/end date | 01/08/07 → 31/07/08 |
Keywords
- speech shunt stenosis
- spasmodic dysphonia
- subglottic pressure
- false cordbulging
- laser surgery.
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