Objective acoustic and aerodynamic analyses of voice after frontal anterior laryngectomy with epiglottoplasty

Objective: In this study, we aimed to perform an objective analysis of the acoustic and aerodynamic characteristics of voice during the preoperative period and the early and late postoperative periods among patients who had undergone frontal anterior laryngectomy with epiglottoplasty (FALE) to determine the degree to which voice was affected after surgery. Methods: The study group included 21 subjects who had undergone FALE. Subjective evaluations were performed using the Grade, Roughness, Breathiness, Asthenia, Strained (GRBAS) scale and the Turkish version of the Voice Handicap Index (VHI). Objective evaluations were performed through voice analyses of voice recordings from the preoperative, 3-month postoperative, and 1-year postoperative periods. The analyzed parameters included fundamental frequency (F0) determination, shimmer %, jitter %, noise-to-harmonic ratio (NHR), variability of the fundamental frequency (VF0), amplitude perturbation quotient (APQ), and soft phonation index (SPI). Results: Subjective voice evaluations revealed that subjects generally reported that their voice was adequate, while physicians using the GRBAS scale generally found that patients exhibited hoarseness and weakness, which they interpreted as a moderate-to-severe voice disorder. Laryngostroboscopic evaluation revealed that most patients showed a longitudinal and irregular glottal closure defect. Conclusion: Our results indicated that patients had a dysphonic voice during the early and late postoperative periods after FALE; however, they exhibited adequate speaking and respiratory functions. Thus, FALE can be considered a surgical technique that preserves the patient’s voice to a degree acceptable to continue professional and other activities, despite voice quality disruption.