Quantitative videofluoroscopy: a new evaluation tool for tracheoesophageal voice production.

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.