High-speed digital imaging of neoglottic vibration after total laryngectomy

Objectives: To establish the applicability of digital highspeed imaging in studying neoglottic mucosal vibration after total laryngectomy and to perfo rm a structured evaluation of the recordings using a standardized assessmen t form to gain insight about the anatomical and morphologic characteristics of the neoglottis. Design: Evaluation of a new clinical tool and description of clinical disor ders in a patient survey. Setting: The Netherlands Cancer Institute, Amsterdam. Patients: Forty-six patients who underwent laryngectomy, 36 who underwent s tandard total laryngectomy and 10 who underwent a partial or to tal pharynx reconstruction tie, myocutaneous pectoralis major flap [n = 4], free radia l forearm flap [n = 2], tubed gastric pull-up [n = 3], and full gastric pul l-up [n = 1]). Intervention: Digital high-speed imaging, using a 90 degrees rigid laryngos cope, of the neoglottic vibration in prosthetic tracheoesophageal speakers after total laryngectomy. Main Outcome Measures: Digital high-speed imaging might overcome some of th e problems of stroboscopy in studying irregular voices and could, therefore , be expected to give more insight into the anatomical and morphologic char acteristics of the neoglottis. Results: Digital high-speed recordings could be obtained in 44 of 46 patien ts. Using a structured evaluation form, a wide variability in anatomical an d morphologic features could be established. Conclusions: Digital high-speed imaging appeared to be a useful tool in stu dying the irregular vibrations of the neoglottis. Evaluation by the structu red evaluation form gives a good idea about the wide variability in anatomi cal and morphologic features of the neoglottis.