Supracricoid partial laryngectomy: Swallowing, voice, and speech outcomes

Objectives: The purpose of the study was to describe the swallowing and vocal function of patients after supracricoid partial laryngectomy (SCPL) as they changed over the first postoperative year. Methods: Ten patients with laryngeal carcinoma underwent SCPL at Johns Hopkins Hospital between August 2003 and May 2005. Clinical and videofluoroscopic swallowing examinations and perceptual, acoustic, aerodynamic, and videostroboscopic voice evaluations were completed before operation and at 3 weeks (swallowing only) and 2 (voice only), 6, and 12 months after operation. Results: The mean time to gastrostomy tube removal was 82 days. The patients tolerated an increased variety of foods over the first postoperative year. All patients initially used therapeutic strategies to swallow safely, and some still required them at 1 postoperative year. Over the year, the perceptual ratings of voice quality improved significantly. There were no consistent changes in acoustic or aerodynamic measures. The number of patients who used multiple vibratory sources to phonate increased over the year. Conclusions: The patients tolerated regular diets, yet continued to exhibit silent aspiration and a variety of decompensations. Their voices were breathy, rough, and strained. Their voice quality ratings improved over the year. Group changes were not captured, and it appears that the changes in speech and voice 2 months after surgery were subtle.