A comparative study of speech after total laryngectomy and total laryngopharyngectomy.

Quality of voice is an important factor in the consideration of treatment for advanced laryngeal cancer. This prospective study compared the speaking proficiency of patients who used the Blom-Singer valve after total laryngectomy and after total laryngopharyngectomy with jejunal graft reconstruction with that of a group of normal subjects. The total laryngectomy group demonstrated excellent communication ability both face-to-face and on the telephone. They exhibited superior scores for objective intelligibility, subjective intelligibility, acceptability, and intonation when compared with the total laryngopharyngectomy group. Both surgical groups produced similar amplitude and frequency parameters during normal conversation but had limited reserve when these functions were stressed. Despite these quantitative variations, patient acceptance was very high in both surgical groups. These results serve as a foundation for the evaluation and improvement of rehabilitation techniques.