Phonatory Movement of the Pharyngoesophageal Mucosa in Laryngectomy Patients

NCT ID: NCT05561920

Last Updated: 2024-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

52 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-08-01

Study Completion Date

2025-05-31

Brief Summary

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Therapy of advanced cancer of the larynx includes excision of the entire larynx. After the removal of the larynx, the pharyngoesophageal segment (PES) is created by reconstruction of the soft tissue of the pharynx and oesophagus, and its vibration creates a replacement voice. High-speed video endoscopy (HSV) is the only method that visualizes and measures vibration of pharyngoesophageal mucosa (PEM) after laryngectomy. Acoustic characteristics of three forms of the rehabilitated voice of laryngectomized persons (oesophageal voice, tracheoesophageal voice using a speech prosthesis and electrolarynx) have been satisfactorily described but, the interdependence of acoustic and visual representations of the phonatory movement of the PES is still insufficiently investigated. In recent years, the development of biomechanical models is created to analyse the vibration of the PES, but still no uniform results have been achieved that would explain whether the parameters obtained from the analysis of the waveform of the PES can be compared with the parameters obtained from the acoustic analysis of the voice of a laryngectomized patients

Detailed Description

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The first aim of this study is to describe phonatory movement of PEM in laryngectomy patients with HSV and then with biomechanical model, analyse these recordings and examine relationship between the obtained parameters and the parameters obtained using the acoustic analysis of the voice of a laryngectomized person. Secondary aim is to assess the impact of loss of voice in terms of psychological and socioeconomic problems in laryngectomy patients using Croatian version of the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL:HR) questionnaire and to examine whether there is a connection between the parameters obtained from the analysis of acoustic recordings and HSV recordings with the results of the questionnaire i.e., with better or worse postoperative adaptation and satisfaction with the replacement voice.

This is a non-interventional, prospective study of laryngectomised participants who completed oncological treatment and underwent voice rehabilitation. The data will be collected at the Clinical Department for Otorhinolaryngology and Head and Neck Surgery - University Hospital Centre, Osijek, Clinical Department for Otorhinolaryngology and Head and Neck Surgery - University Hospital Centre, Zagreb.

In the first phase of the research, translation and cultural adaptation of a Croatian version of the SECEL questionnaire will be carried out ( ClinicalTrials.gov Identifier: NCT05346237).

Second phase will enrol approximately 50 laryngectomised participants independent from the first phase of research. Data on surgical and oncological treatment, voice rehabilitation method, comorbidities and drug therapy will be collected retrospectively from the patient's medical histories. Ear,nose and throat examination and endoscopic evaluation of swallowing will be performed in order to rule out the presence of non-eligibility criteria. All subjects will fill out a validated questionnaire in Croatian (SECEL:HR). Voice production time will be measured, and subjects will undergo acoustical voice assessment and HSV during voice production. The visualisation of the pharyngoesophageal segment itself will be analysed - phase closure, pharyngoesophageal segment shape (circular, triangular, split side to side, split anterior-posterior, irregular), then the presence and location of visible vibration, and the presence of a mucosal wave. For the processing of HSV videos a computer program will be developed. Based on the collected data, the parameters of the assumed multi-mass coupled biomechanical model will be identified and compared with the acoustic recording of each respondent.

Conditions

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Larynx Cancer Laryngectomy; Status

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Adult laryngectomised patients

Patients who have undergone total laryngectomy and completed minimal their 6-month period without disease after surgery and post-operative treatments such as radiotherapy or chemotherapy

High - speed video endoscopy (HSV)

Intervention Type DEVICE

Describe anatomical and morphological characteristics o phonatory movement of PEM in laryngectomy patients

Acoustic voice analysis

Intervention Type DEVICE

acoustic program (lingWAVES - Voice and speech analyser) - measuring the values of acoustic parameters in voice recordings

Quality of life questionnaire

Intervention Type BEHAVIORAL

Filling out questionnaires

Interventions

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High - speed video endoscopy (HSV)

Describe anatomical and morphological characteristics o phonatory movement of PEM in laryngectomy patients

Intervention Type DEVICE

Acoustic voice analysis

acoustic program (lingWAVES - Voice and speech analyser) - measuring the values of acoustic parameters in voice recordings

Intervention Type DEVICE

Quality of life questionnaire

Filling out questionnaires

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* laryngectomised patients who completed minimal their 6-month period without disease after surgery and post-operative treatments such as radiotherapy or chemotherapy
* patients with preserved reading skills
* regular presence at follow-up visits

Exclusion Criteria

* age less than 18 years
* acute respiratory infection of the upper or lower respiratory tract
* other primary cancer in the upper aerodigestive tract or lung
* presence of neurologic or pulmonary diseases
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Josip Juraj Strossmayer University of Osijek

OTHER

Sponsor Role collaborator

Osijek University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ana Đanić Hadžibegović, Assoc. Prof

Role: STUDY_CHAIR

Clinical Hospital Centre Zagreb

Andrijana Včeva, Full Prof

Role: STUDY_CHAIR

University Hospital Osijek

Locations

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University Hospital Osijek

Osijek, Osijek, Croatia

Site Status RECRUITING

Countries

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Croatia

Central Contacts

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Željka Laksar Klarić, M.D.

Role: CONTACT

+38598666494

Facility Contacts

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Željka Laksar Klarić, M.D.

Role: primary

+38598666494

References

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Zenga J, Goldsmith T, Bunting G, Deschler DG. State of the art: Rehabilitation of speech and swallowing after total laryngectomy. Oral Oncol. 2018 Nov;86:38-47. doi: 10.1016/j.oraloncology.2018.08.023. Epub 2018 Sep 12.

Reference Type BACKGROUND
PMID: 30409318 (View on PubMed)

van As CJ, Tigges M, Wittenberg T, Op de Coul BM, Eysholdt U, Hilgers FJ. High-speed digital imaging of neoglottic vibration after total laryngectomy. Arch Otolaryngol Head Neck Surg. 1999 Aug;125(8):891-7. doi: 10.1001/archotol.125.8.891.

Reference Type BACKGROUND
PMID: 10448737 (View on PubMed)

Schwarz R, Huttner B, Dollinger M, Luegmair G, Eysholdt U, Schuster M, Lohscheller J, Gurlek E. Substitute voice production: quantification of PE segment vibrations using a biomechanical model. IEEE Trans Biomed Eng. 2011 Oct;58(10):2767-76. doi: 10.1109/TBME.2011.2151860. Epub 2011 May 10.

Reference Type BACKGROUND
PMID: 21558056 (View on PubMed)

Huttner B, Luegmair G, Patel RR, Ziethe A, Eysholdt U, Bohr C, Sebova I, Semmler M, Dollinger M. Development of a time-dependent numerical model for the assessment of non-stationary pharyngoesophageal tissue vibrations after total laryngectomy. Biomech Model Mechanobiol. 2015 Jan;14(1):169-84. doi: 10.1007/s10237-014-0597-1. Epub 2014 May 27.

Reference Type BACKGROUND
PMID: 24861998 (View on PubMed)

Schlegel P, Stingl M, Kunduk M, Kniesburges S, Bohr C, Dollinger M. Dependencies and Ill-designed Parameters Within High-speed Videoendoscopy and Acoustic Signal Analysis. J Voice. 2019 Sep;33(5):811.e1-811.e12. doi: 10.1016/j.jvoice.2018.04.011. Epub 2018 May 31.

Reference Type BACKGROUND
PMID: 29861291 (View on PubMed)

Schindler A, Mozzanica F, Brignoli F, Maruzzi P, Evitts P, Ottaviani F. Reliability and validity of the Italian self-evaluation of communication experiences after laryngeal cancer questionnaire. Head Neck. 2013 Nov;35(11):1606-15. doi: 10.1002/hed.23198. Epub 2012 Nov 20.

Reference Type BACKGROUND
PMID: 23169480 (View on PubMed)

Debruyne F, Delaere P, Wouters J, Uwents P. Acoustic analysis of tracheo-oesophageal versus oesophageal speech. J Laryngol Otol. 1994 Apr;108(4):325-8. doi: 10.1017/s0022215100126660.

Reference Type BACKGROUND
PMID: 8182320 (View on PubMed)

Dooks P, McQuestion M, Goldstein D, Molassiotis A. Experiences of patients with laryngectomies as they reintegrate into their community. Support Care Cancer. 2012 Mar;20(3):489-98. doi: 10.1007/s00520-011-1101-4. Epub 2011 Feb 6.

Reference Type BACKGROUND
PMID: 21298450 (View on PubMed)

Other Identifiers

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OsijekUH-HS camera

Identifier Type: -

Identifier Source: org_study_id

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