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Original Article
February 2001

Quantitative Videofluoroscopy: A New Evaluation Tool for Tracheoesophageal Voice Production

Author Affiliations

From the Department of Otolaryngology–Head and Neck Surgery, the Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam (Drs van As and Hilgers), Institute of Phonetic Sciences, University of Amsterdam, Amsterdam (Drs van As and Koopmans–van Beinum), and Department of Otolaryngology/Head and Neck Surgery, University Hospital St Radboud, Nijmegen (Drs Op de Coul and van den Hoogen), the Netherlands.

Arch Otolaryngol Head Neck Surg. 2001;127(2):161-169. doi:10.1001/archotol.127.2.161

Objective  To develop a quantitative videofluoroscopy protocol using well-defined visual parameters and quantitative measures for the evaluation of anatomical and morphologic characteristics of the neoglottis in relation to perceptual evaluation of tracheoesophageal voice quality.

Design  A patient survey.

Setting  The Netherlands Cancer Institute, Amsterdam.

Patients  Thirty-nine individuals with laryngectomies, 30 with standard total laryngectomy and 9 with a partial or total pharynx reconstruction.

Interventions  Videofluoroscopy, speech recordings.

Main Outcome Measures  Well-defined visual parameters and quantitative measures based on videofluoroscopy images should improve the evaluation of neoglottic characteristics in relation to voice quality.

Results  Quantitative measures were significantly related to visual assessment outcomes. Tonicity (P=.02) and presence of a neoglottic bar during phonation (P=.03) were significantly related to voice quality, as were several quantitative measures, especially the minimal distance between the neoglottic bar and anterior esophageal wall at rest (P<.001) and during phonation (P=.02), and the index for the relative increase of the maximal subneoglottic distance from rest to phonation (P=.01).

Conclusions  This new quantitative videofluoroscopy protocol is a useful tool 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 laryngectomy.