Voice Findings after Laryngeal Fracture

Vintturi J, Juutilainen M, Mäkitie AA

Long-term (2-108 months) vocal consequences after laryngeal fracture and its management were studied in 33 consecutive patients (14 — 84 yrs.). The voice was graded subjectively by the patient as good if it resembled the voice before the trauma (n="20;" 61%), fair if it was altered but still functional (n ="13;" 39%) and poor if the result was aphonia (0%). Patients with suboptimal voice result were further invited to a phoniatric consultation and eight patients attended (2 females, 6 males). Phoniatric evaluation consisted of videolaryngoscopy and estimation of voice including GRBAS rating. The voice samples were also analyzed using Multi-Dimensional Voice Program (Kay Elemetrics). The dynamic range of the voice was studied using Voice Range Profile (Schutte and Seidner 1983).
Majority of the patients (6 / 8) were unable to stretch the vocal folds, which was characterized by bowing of the vocal folds as well. Therefore, they were unable to produce high pitched voices. The difficulty might be due either to altered configuration of the larynx or paresis of the superior laryngeal nerve and, thus, cricothyroid muscle dysfunction. EMG of the larynx might give more information on this issue. All the males lacked the ability to produce falsetto sounds, and the voice range was reduced. The speaking voice was characterized by hoarse, breathy and pressed qualities. In computerized voice analysis, all the males and the other of the two females showed pathological values (e.g., pitch and amplitude perturbation elevated, soft phonation index elevated). The intensity range of the voice was restricted, especially at the upper limit.
Schutte HK, Seidner W. Recommendation by the Union of European Phoniatricians (UEP): Standardizing voice area measurement / Phonetography. Folia Phoniatr 1983;35:286-8.
Keywords: Larynx, trauma, voice

Vintturi J 1), Juutilainen M 2), Mäkitie AA 2)
1) Department of Phoniatrics, Helsinki University Central Hospital, P.O.Box 220, FIN-00029 HUCH, Helsinki, Finland
2) Department of Otolaryngology - Head & Neck Surgery, Helsinki University Central Hospital, P.O.Box 220, FIN-00029 HUCH, Helsinki, Finland

Dr. Juha Vintturi
Department of Phoniatrics,
HelsinkiUniversity Central Hospital,
P.O.Box220, FIN-00029 HUCH,
Helsinki, Finland
Tel: +358 - 9 - 4711 Fax: +358 - 9 - 4717 5922
E-mail: juha.vintturi@hus.fi