Quantitative videofluoroscopy - A new evaluation tool for tracheoesophageal voice production

Objective: To develop a quantitative videofluoroscopy protocol using well-d efined visual parameters and quantitative measures for the evaluation of an atomical and morphologic characteristics of the neoglottis in relation to p erceptual evaluation of tracheoesophageal voice quality. Design: A patient survey. Setting: The Netherlands Cancer Institute, Amsterdam. Patients: Thirty-nine individuals with laryngectomies, 30 with standard tot al laryngectomy and 9 with a partial or total pharynx reconstruction. Interventions: Videofluoroscopy, speech recordings. Main Outcome Measures: Well-defined visual parameters and quantitative meas ures based on videofluoroscopy images should improve the evaluation of neog lottic characteristics in relation to voice quality. Results: Quantitative measures were significantly related to visual assessm ent outcomes. Tonicity (P=.02) and presence of a neoglottic bar during phon ation (P=.03) were significantly related to voice quality, as were several quantitative measures, especially the minimal distance between the neoglott ic bar and anterior esophageal wall at rest (P<.001) and during phonation ( P=.02), and the index for the relative increase of the maximal subneoglotti c distance from rest to phonation (P=.01). Conclusions: This new quantitative videofluoroscopy protocol is a useful to ol for the study of the anatomy and morphology of the neoglottis. With this protocol, characteristics relevant to tracheoesophageal voice quality can be defined. The quantitative measures are promising for a more standardized evaluation of the neoglottis in individuals who have undergone laryngectom y.