Hands-over-mouth exercise in supracricoid horizontal partial laryngectomy: initial study

Revista da Sociedade Brasileira de Fonoaudiologia

Gonçalves, Antônio José¹  Fouquet, Marina Lang¹  Vieira, Tais Pichirilli Guilherme¹  Santa Casa de São Paulo, São Paulo, Brasil¹  Murata, Claudio José Massao¹ 

关键词: Laringectomy;    Supracricoid laryngectomy;    Voice;    Voice quality;    Voice training;   

DOI  :  10.1590/S1516-80342012000300018

来源: Sociedade Brasileira de Fonoaudiologia

【 摘 要 】

Supracricoid horizontal partial laryngectomy is a surgical technique used to treat laryngeal tumors restricted to glottic and supraglottic regions, preserving at least one of the arytenoids. This surgery allows for maintenance of the sphincter and respiratory functions, as well as phonation, with rough vocal quality. Rehabilitation aims to promote sphincter contraction of the remaining structures to improve swallowing and phonation. The hands-over-mouth exercise is usually employed to improve glottic closure: one cupped hand gently covers the half-open mouth to almost completely obstruct the airway during sustained emission of a voiced fricative phoneme. To understand the effect of this technique in patients submitted to supracricoid laryngectomy, we evaluated the configuration of the laryngeal remaining structures and vocal quality during supraglottic phonation, after a hands-over-mouth exercising period of two-minutes, by comparing digitizing voice samples and nasolaryngoscopic images of six patients, before and after the task. We used the GRBASI scale to access vocal quality and analyzed the pattern of constriction, the degree of approximation and the vibratory amplitude to evaluate the images. In this pilot, we observed an increase in vibratory amplitude of the remaining structures of five patients and concluded that the hands-over-mouth exercise can be used as a complementary exercise to improve supraglottic voice quality.

【 授权许可】

Unknown