Phonatory Flap Wave in Platysma Skin Flap: Functional Evaluation and Influencing Factors Analysis

Area of Science:

• Otolaryngology
• Speech and Voice Science
• Surgical Reconstruction

Background:

• Laryngeal defects often require surgical repair, with platysma skin flaps being a common method.
• Postsurgical voice quality is a significant concern for patients undergoing laryngectomy.
• Understanding factors influencing flap vibration is crucial for optimizing voice outcomes.

Purpose of the Study:

• To analyze the phonatory function of the phonatory flap vibrational wave (PFVW).
• To identify factors influencing PFVW formation, specifically the tissue structure of the platysma skin flap.
• To enhance postsurgical voice quality in patients with laryngeal defects repaired by platysma skin flaps.

Main Methods:

• Retrospective analysis of patients with unilateral glottic laryngeal cancer (T2-3N0-2M0) or laryngeal squamous cell carcinoma.
• Repair of defects using platysma skin flaps after vertical partial laryngectomy.
• Postoperative voice analysis (fundamental frequency, jitter, shimmer, GRBAS scale) and stroboscopic laryngoscopy.

Main Results:

• Patients with PFVW at 3 months showed significantly better voice parameters (jitter, shimmer, MPT) and lower GRBAS scores at 6 months.
• Subcutaneous fat thickness of the platysma flap was a significant predictive factor for PFVW occurrence (OR=7.835, p=0.003).
• Higher subcutaneous fat thickness correlated with improved voice quality post-reconstruction.

Conclusions:

• Subcutaneous fat tissue thickness beneath the platysma muscle is a critical determinant of PFVW occurrence.
• Optimizing platysma flap fat tissue may improve voice outcomes after vertical partial laryngectomy.
• PFVW presence is associated with better functional voice outcomes post-reconstruction.