Larynx CancerNCT05561920
Phonatory Movement of the Pharyngoesophageal Mucosa in Laryngectomy Patients
An observational study of Larynx Cancer and Laryngectomy; Status, run by Osijek University Hospital at 1 site in Croatia.
Trial summary
The treatment of advanced laryngeal cancer involves the removal of the entire larynx. After removal of the larynx, the pharyngoesophageal segment (PES) is created by reconstructing the soft tissue of the pharynx and oesophagus, and its vibration creates a substitute voice. Read more about this study
- Who is it for?
- Ages 18 to 90 years
- Conditions the study is for
- Larynx Cancer, Laryngectomy; Status
- What is being tested?
- High-speed video endoscopy (HSV), Acoustic voice analysis and Quality of life questionnaire
- Type of treatment
- Medical device, Lifestyle or therapy programme
- How many people
- 55 participants
- Where
- 1 siteCroatia
- Study dates
- 1 Aug 2022to 1 Apr 2025
- Phase
- Observational
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: adult male laryngectomised patients who completed oncological treatment and underwent voice rehabilitation
Who may be able to join
- 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
Who cannot join
- 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
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Dependencies of Acoustic Signal and Image Recordings of Phonatory Movement of the Pharyngoesophageal Mucosa in Laryngectomy Patients Using High-speed Video Endoscopy and a Biomechanical Model
The treatment of advanced laryngeal cancer involves the removal of the entire larynx. After removal of the larynx, the pharyngoesophageal segment (PES) is created by reconstructing the soft tissue of the pharynx and oesophagus, and its vibration creates a substitute voice. High-speed video endoscopy (HSV) is the only method that visualises and measures the vibration of the PES after a laryngectomy. The acoustic characteristics of three forms of rehabilitated voice of laryngectomised individuals (oesophageal voice, tracheoesophageal (TE) voice using a voice 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 studied. In recent years, biomechanical models have been developed to analyse the vibration of the PES, but consistent results have not yet been obtained that would explain whether the parameters 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 laryngectomised patient.Effective rehabilitation focuses on optimising speech and swallowing, which leads to a good integration of the laryngectomised person into society. One step towards achieving this goal is a thorough assessment of their voice and communication experiences, as well as analysing the phonatory movements of the PES using HSV technology.
Read the detailed description
The first aim of this study is to describe phonatory movement of pharyngoesophageal segment (PES) in laryngectomy patients with HSV and then with biomechanical model. Analyse these recordings and examine 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.
This is a non-interventional, prospective study of laryngectomised participants ( 55 participants) who completed oncological treatment and underwent voice rehabilitation. A consent form will be signed.
Exclusion criteria included individuals with acute upper or lower respiratory tract infections, a second primary cancer in the upper aerodigestive tract or lungs, and individuals with neurological or psychiatric disorders.
Each participant underwent a complete otolaryngological examination. The video recordings of the PES were made with a 90° rigid HSV system Wolf 5562 Hres ENDOCAM (frame rate: 4000 fps, resolution: 256×256 pixels). All subjects phonated the vowel "a" at a comfortable pitch and volume. Visual assessment of the HSV recordings was performed including the assessments of the overall quality of the recordings and the assessments of anatomical and morphological features of the PES: amount of saliva, visibility and shape of the PES, location of visible vibration, presence of a mucosal wave and regularity of the vibration.
Each respondent completed the Croatian version of the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL:HR) questionnaire, specifically designed to address the communication needs of patients who have undergone a laryngectomy. The first part of SECEL:HR examines patient-relevant data, while the second part consists of 35 items designed as questions or statements to explore communication experiences. Patients rate the frequency of these communication difficulties on a Likert scale (0-never, 1-sometimes, 2-often, 3-always). The 35 items are divided into 3 subscales: General (0-15 points), Environment (0-42 points) and Attitude (0-45 points). Item number 35 is a separate question: "Do you talk the same amount now as you did before your laryngectomy?" and is scored with the rating categories "yes"," "more" and "less". The total numerical score ranges from 0 to 102, with a higher score indicating greater difficulty and poorer postoperative adaptation of speech communication.
The acoustic analysis of the tracheoesophageal (TE) voice with a voice prosthesis was performed in a quiet room (ambient noise < 50 dB) with a microphone placed 30 cm from the mouth to create optimal conditions for recording and analysis. Three consecutive measurements were taken. The voice recordings were analysed using the acoustic programme lingWAVES (Voice and speech analyser version 2.x software). The following parameters were recorded from the central part of the best recording: fundamental frequency (F0) (Hz), jitter (%), shimmer (%) and the intensity of substitute voice (dB). The value of the maximal phonation time (MPT; ms) was taken as the value of the longest possible relaxed phonation of the vowel "a".
A multi-mass coupled biomechanical model was developed as a multidimensional time sequence of PES mucosal contractions in the form of the opening width observed for each frame of the video time sequence at different angles.
The biomechanical model of the PES analyses non-stationary pharyngoesophageal vibrations and draws conclusions about the temporal characteristics of tissue stiffness, oscillatory mass, pressure and geometric distributions within the PES. The biomechanical model identifies mathematical dependencies and analyses extracted time signals of the PES opening and contours (i.e. the opening and closing of the vibrating mucosa of the PES). Using the PES waveform, we were able to calculate cycle duration, open and closed phase duration (%), fundamental frequency (Hz), mean shimmer (dB), relative shimmer (%), mean jitter (s) and relative jitter (%).
- Conditions
- Larynx Cancer, Laryngectomy; Status
- Being tested
- High-speed video endoscopy (HSV), Acoustic voice analysis, Quality of life questionnaire
- Keywords
- Laryngectomy, Endoscopy, Speech,acoustics, High speed imaging, Speech,alaryngeal, Pharyngoesophageal segment, Biomechanics model
- Medical subject headings
- Laryngeal Neoplasms, Speech
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
High-speed video endoscopy (HSV)Device
Describe anatomical and morphological characteristics o phonatory movement of pharyngoesophageal segment (PES) in laryngectomy patients
Acoustic voice analysisDevice
acoustic program (lingWAVES - Voice and speech analyser) - measuring the values of acoustic parameters in voice recordings
Quality of life questionnaireBehavioural
Filling out questionnaires
| Study group | Role | What they receive |
|---|---|---|
| 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 Receives: Device: High-speed video endoscopy (HSV); Device: Acoustic voice analysis; Behavioral: Quality of life questionnaire |
What is being measured
The primary outcome is the main question the study is designed to answer.
High Speed Video Endoscopy Recordings
Visual recording of the mucosa of the pharyngoesophageal segment (PES) performed with High speed video endoscopy (HSV) during the phonation of the vowel "a".The video recordings of the PES were made with a 90° rigid HSV system Wolf 5562 Hres ENDOCAM (frame rate: 4000 fps, resolution: 256×256 pixels). All subjects phonated the vowel "a" at a comfortable pitch and volume. Visual assessment of the HSV recordings was performed using the protocol including the assessments of the overall quality of the recordings (assessability, brightness and focus) and the assessments of anatomical and morphological features of the PES: amount of saliva, visibility and shape of the PES, location of visible vibration, presence of a mucosal wave and regularity of the vibration.
Measured: 15 minutes for each participants
The Measures of Central Tendency and Dispersion in Acoustic Signal - Fundamental Frequency
The acoustic analysis of the tracheoesophageal (TE) voice with a voice prosthesis was performed in a quiet room (ambient noise < 50 dB) with a microphone placed 30 cm from the mouth to create optimal conditions for recording and analysis. Three consecutive measurements were taken. The voice recordings were analysed using the acoustic programme lingWAVES (Voice and speech analyser version 2.x software). The fundamental frequency (Hz) parameter was recorded from the central part of the best recording
Measured: 15 minutes
The Measures of Central Tendency and Dispersion in Acoustic Signal - Intensity of Substitute Voice
The acoustic analysis of the tracheoesophageal (TE) voice with a voice prosthesis was performed in a quiet room (ambient noise < 50 dB) with a microphone placed 30 cm from the mouth to create optimal conditions for recording and analysis. Three consecutive measurements were taken. The voice recordings were analysed using the acoustic programme lingWAVES (Voice and speech analyser version 2.x software). Intensity of substitute voice was recorded from the central part of the best recording
Measured: 15 minutes
The Measures of Central Tendency and Dispersion in Acoustic Signal - Relative Jitter and Shimmer
The acoustic analysis of the tracheoesophageal (TE) voice with a voice prosthesis was performed in a quiet room (ambient noise < 50 dB) with a microphone placed 30 cm from the mouth to create optimal conditions for recording and analysis. Three consecutive measurements were taken. The voice recordings were analysed using the acoustic programme lingWAVES (Voice and speech analyser version 2.x software). The following parameters were recorded from the central part of the best recording: jitter (%), shimmer (%)
Measured: 15 minutes
The Measures of Central Tendency and Dispersion of Maximum Phonation Time (MPT)
Measurement of the longest possible relaxed phonation of the voice "a" by a speech therapist
The maximum phonation time (measured in seconds) for which a person can sustain a vowel sound when produced on 1 deep breath at a comfortable pitch and loudness and is a common clinical measure of glottal efficiency.
Measured: 2 minutes
Croatian Version of the SECEL (SECEL:HR) Questionnaire.
Completing the Croatian version of the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) questionnaire. Questionnaire consists of two parts. The first part examines the relevant general data on the person filling out the questionnaire, while the second part consists of 35 items questionably or statement-designed to examine communication experiences. Patients estimates the incidence of these communication difficulties on the Likert scale (0-never, 1-sometimes, 2-often, 3-always). The 35 items are divided into 3 subscales: General (0-15 points), Environment (0-42 points) and Attitude (0-45 points). Item number 35 is a separate question: "Do you talk the same amount now as you did before your laryngectomy?" and is scored with the rating categories "yes"," "more" and "less". The total numerical score ranges from 0 to 102, with a higher score indicating greater difficulty and poorer postoperative adaptation of speech communication.
Measured: 15 minutes
The Results of Pharyngoesophageal Segment (PES) Vibration Analysed With the Biomechanical Model Obtained by High - Speed Video Endoscopy - Central Tendency and Dispersion - Open and Closed Phase Duration (%), Relative Shimmer and Relative Jitter
The development of the biomechanical model of the PES aims to quantify non-stationary pharyngoesophageal vibrations and draw conclusions about the temporal characteristics of tissue stiffness, oscillating mass, pressure, and geometric distributions within the PES. The biomechanical model identifies mathematical dependencies and analyses extracted time signals of the PES opening and contours (i.e. the opening and closing of the vibrating mucosa of the PES). The PES waveform allows calculation of relative shimmer (%), relative jitter (%), and the duration of the open and closed phases (%), or the percentage of open or closed time of the PES, which is calculated from the PES waveform using the formulas listed in reference 5.
Measured: 3 months
The Results of Pharyngoesophageal Segment (PES) Vibration Analysed With the Biomechanical Model Obtained by High - Speed Video Endoscopy - Central Tendency and Dispersion - Mean Shimmer
The development of the biomechanical model of the PES in order to quantify non-stationary pharyngoesophageal vibrations and drawing conclusions on the temporal characteristics of tissue stiffness, oscillating mass, pressure, and geometric distributions within the PES. The biomechanical model identify mathematical dependencies and analyse extracted time signals of the PES opening and contours (i.e. the opening and closing of the vibrating mucosa of the PES). The PES waveform allowed us to calculate mean shimmer (dB).
Measured: 3 months
The Results of Pharyngoesophageal Segment (PES) Vibration Analysed With the Biomechanical Model Obtained by High - Speed Video Endoscopy - Central Tendency and Dispersion of Mean Jitter
The development of the biomechanical model of the PES in order to quantify non-stationary pharyngoesophageal vibrations and drawing conclusions on the temporal characteristics of tissue stiffness, oscillating mass, pressure, and geometric distributions within the PES. The biomechanical model identify mathematical dependencies and analyse extracted time signals of the PES opening and contours (i.e. the opening and closing of the vibrating mucosa of the PES). The PES waveform allowed us to calculate mean jitter (s).
Measured: 3 months
The Results of Pharyngoesophageal Segment (PES) Vibration Analysed With the Biomechanical Model Obtained by High - Speed Video Endoscopy - Central Tendency and Dispersion - Fundamental Frequency
The development of the biomechanical model of the PES in order to quantify non-stationary pharyngoesophageal vibrations and drawing conclusions on the temporal characteristics of tissue stiffness, oscillating mass, pressure, and geometric distributions within the PES. The biomechanical model identify mathematical dependencies and analyse extracted time signals of the PES opening and contours (i.e. the opening and closing of the vibrating mucosa of the PES). The PES waveform allowed us to calculate the fundamental frequency (Hz).
Measured: 3 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Sep 2022
- Study start1 Aug 2022
- Primary completion1 Apr 2025
- Study completion1 Apr 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for Larynx CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 55 participants (actual)
Sponsor and investigators
- Lead sponsor
- Osijek University Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Josip Juraj Strossmayer University of Osijek
- Responsible party
- Sponsor
- Investigators
- Ana Đanić Hadžibegović, Assoc. Prof, Study chair, Clinical Hospital Centre ZagrebAndrijana Včeva, Full Prof, Study chair, University Hospital Osijek
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05561920
- Sponsor's protocol ID
- OsijekUH-HS camera
- Status last verified
- Jun 2025
- First submitted
- 15 Sep 2022
- Last updated
- 31 Mar 2026
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
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.
PubMed 30409318van 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.
PubMed 10448737Schwarz 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.
PubMed 21558056Huttner 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.
PubMed 24861998Schlegel 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.
PubMed 29861291Schindler 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.
PubMed 23169480Debruyne 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.
PubMed 8182320Dooks 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.
PubMed 21298450
Study at a glance
From the registry record, last updated by the sponsor on 31 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Dependencies of Acoustic Signal and Image Recordings of Phonatory Movement of the Pharyngoesophageal Mucosa in Laryngectomy Patients Using High-speed Video Endoscopy and a Biomechanical Model
- ClinicalTrials.gov ID
- NCT05561920
- Acronym / sponsor ID
- OsijekUH-HS camera
- Conditions
- Larynx Cancer, Laryngectomy; Status
- Keywords
- Laryngectomy, Endoscopy, Speech,acoustics, High speed imaging, Speech,alaryngeal, Pharyngoesophageal segment, Biomechanics model
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 55 participants (actual)
- Lead sponsor
- Osijek University HospitalUniversity, hospital or other
- Collaborators
- Josip Juraj Strossmayer University of Osijek
- Study start
- 1 Aug 2022 (actual)
- Primary completion
- 1 Apr 2025 (actual)
- Study completion
- 1 Apr 2025 (actual)
- First posted
- 30 Sep 2022 (actual)
- Results
- Posted 11 Mar 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The treatment of advanced laryngeal cancer involves the removal of the entire larynx. After removal of the larynx, the pharyngoesophageal segment (PES) is created by reconstructing the soft tissue of the pharynx and oesophagus, and its vibration creates a substitute voice. High-speed video endoscopy (HSV) is the only method that visualises and measures the vibration of the PES after a laryngectomy. The acoustic characteristics of three forms of rehabilitated voice of laryngectomised individuals (oesophageal voice, tracheoesophageal (TE) voice using a voice 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 studied. In recent years, biomechanical models have been developed to analyse the vibration of the PES, but consistent results have not yet been obtained that would explain whether the parameters 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 laryngectomised patient.Effective rehabilitation focuses on optimising speech and swallowing, which leads to a good integration of the laryngectomised person into society. One step towards achieving this goal is a thorough assessment of their voice and communication experiences, as well as analysing the phonatory movements of the PES using HSV technology.
Detailed description
The first aim of this study is to describe phonatory movement of pharyngoesophageal segment (PES) in laryngectomy patients with HSV and then with biomechanical model. Analyse these recordings and examine 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.
This is a non-interventional, prospective study of laryngectomised participants ( 55 participants) who completed oncological treatment and underwent voice rehabilitation. A consent form will be signed.
Exclusion criteria included individuals with acute upper or lower respiratory tract infections, a second primary cancer in the upper aerodigestive tract or lungs, and individuals with neurological or psychiatric disorders.
Each participant underwent a complete otolaryngological examination. The video recordings of the PES were made with a 90° rigid HSV system Wolf 5562 Hres ENDOCAM (frame rate: 4000 fps, resolution: 256×256 pixels). All subjects phonated the vowel "a" at a comfortable pitch and volume. Visual assessment of the HSV recordings was performed including the assessments of the overall quality of the recordings and the assessments of anatomical and morphological features of the PES: amount of saliva, visibility and shape of the PES, location of visible vibration, presence of a mucosal wave and regularity of the vibration.
Each respondent completed the Croatian version of the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL:HR) questionnaire, specifically designed to address the communication needs of patients who have undergone a laryngectomy. The first part of SECEL:HR examines patient-relevant data, while the second part consists of 35 items designed as questions or statements to explore communication experiences. Patients rate the frequency of these communication difficulties on a Likert scale (0-never, 1-sometimes, 2-often, 3-always). The 35 items are divided into 3 subscales: General (0-15 points), Environment (0-42 points) and Attitude (0-45 points). Item number 35 is a separate question: "Do you talk the same amount now as you did before your laryngectomy?" and is scored with the rating categories "yes"," "more" and "less". The total numerical score ranges from 0 to 102, with a higher score indicating greater difficulty and poorer postoperative adaptation of speech communication.
The acoustic analysis of the tracheoesophageal (TE) voice with a voice prosthesis was performed in a quiet room (ambient noise < 50 dB) with a microphone placed 30 cm from the mouth to create optimal conditions for recording and analysis. Three consecutive measurements were taken. The voice recordings were analysed using the acoustic programme lingWAVES (Voice and speech analyser version 2.x software). The following parameters were recorded from the central part of the best recording: fundamental frequency (F0) (Hz), jitter (%), shimmer (%) and the intensity of substitute voice (dB). The value of the maximal phonation time (MPT; ms) was taken as the value of the longest possible relaxed phonation of the vowel "a".
A multi-mass coupled biomechanical model was developed as a multidimensional time sequence of PES mucosal contractions in the form of the opening width observed for each frame of the video time sequence at different angles.
The biomechanical model of the PES analyses non-stationary pharyngoesophageal vibrations and draws conclusions about the temporal characteristics of tissue stiffness, oscillatory mass, pressure and geometric distributions within the PES. The biomechanical model identifies mathematical dependencies and analyses extracted time signals of the PES opening and contours (i.e. the opening and closing of the vibrating mucosa of the PES). Using the PES waveform, we were able to calculate cycle duration, open and closed phase duration (%), fundamental frequency (Hz), mean shimmer (dB), relative shimmer (%), mean jitter (s) and relative jitter (%).
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Adult laryngectomised patients | – | Device: High-speed video endoscopy (HSV), Device: Acoustic voice analysis, Behavioral: Quality of life questionnairePatients 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 |
Who may qualify
- Ages
- 18 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- adult male laryngectomised patients who completed oncological treatment and underwent voice rehabilitation
Key inclusion criteria (3 listed)
- 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
Key exclusion criteria (4 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| High-speed video endoscopy (HSV)Describe anatomical and morphological characteristics o phonatory movement of pharyngoesophageal segment (PES) in laryngectomy patients | Device | Adult laryngectomised patients |
| Acoustic voice analysisacoustic program (lingWAVES - Voice and speech analyser) - measuring the values of acoustic parameters in voice recordings | Device | Adult laryngectomised patients |
| Quality of life questionnaireFilling out questionnaires | Behavioural | Adult laryngectomised patients |
Primary outcome
High Speed Video Endoscopy Recordings
Time frame: 15 minutes for each participants
Visual recording of the mucosa of the pharyngoesophageal segment (PES) performed with High speed video endoscopy (HSV) during the phonation of the vowel "a".The video recordings of the PES were made with a 90° rigid HSV system Wolf 5562 Hres ENDOCAM (frame rate: 4000 fps, resolution: 256×256 pixels). All subjects phonated the vowel "a" at a comfortable pitch and volume. Visual assessment of the HSV recordings was performed using the protocol including the assessments of the overall quality of the recordings (assessability, brightness and focus) and the assessments of anatomical and morphological features of the PES: amount of saliva, visibility and shape of the PES, location of visible vibration, presence of a mucosal wave and regularity of the vibration.
The Measures of Central Tendency and Dispersion in Acoustic Signal - Fundamental Frequency
Time frame: 15 minutes
The acoustic analysis of the tracheoesophageal (TE) voice with a voice prosthesis was performed in a quiet room (ambient noise < 50 dB) with a microphone placed 30 cm from the mouth to create optimal conditions for recording and analysis. Three consecutive measurements were taken. The voice recordings were analysed using the acoustic programme lingWAVES (Voice and speech analyser version 2.x software). The fundamental frequency (Hz) parameter was recorded from the central part of the best recording
The Measures of Central Tendency and Dispersion in Acoustic Signal - Intensity of Substitute Voice
Time frame: 15 minutes
The acoustic analysis of the tracheoesophageal (TE) voice with a voice prosthesis was performed in a quiet room (ambient noise < 50 dB) with a microphone placed 30 cm from the mouth to create optimal conditions for recording and analysis. Three consecutive measurements were taken. The voice recordings were analysed using the acoustic programme lingWAVES (Voice and speech analyser version 2.x software). Intensity of substitute voice was recorded from the central part of the best recording
The Measures of Central Tendency and Dispersion in Acoustic Signal - Relative Jitter and Shimmer
Time frame: 15 minutes
The acoustic analysis of the tracheoesophageal (TE) voice with a voice prosthesis was performed in a quiet room (ambient noise < 50 dB) with a microphone placed 30 cm from the mouth to create optimal conditions for recording and analysis. Three consecutive measurements were taken. The voice recordings were analysed using the acoustic programme lingWAVES (Voice and speech analyser version 2.x software). The following parameters were recorded from the central part of the best recording: jitter (%), shimmer (%)
The Measures of Central Tendency and Dispersion of Maximum Phonation Time (MPT)
Time frame: 2 minutes
Measurement of the longest possible relaxed phonation of the voice "a" by a speech therapist The maximum phonation time (measured in seconds) for which a person can sustain a vowel sound when produced on 1 deep breath at a comfortable pitch and loudness and is a common clinical measure of glottal efficiency.
Croatian Version of the SECEL (SECEL:HR) Questionnaire.
Time frame: 15 minutes
Completing the Croatian version of the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) questionnaire. Questionnaire consists of two parts. The first part examines the relevant general data on the person filling out the questionnaire, while the second part consists of 35 items questionably or statement-designed to examine communication experiences. Patients estimates the incidence of these communication difficulties on the Likert scale (0-never, 1-sometimes, 2-often, 3-always). The 35 items are divided into 3 subscales: General (0-15 points), Environment (0-42 points) and Attitude (0-45 points). Item number 35 is a separate question: "Do you talk the same amount now as you did before your laryngectomy?" and is scored with the rating categories "yes"," "more" and "less". The total numerical score ranges from 0 to 102, with a higher score indicating greater difficulty and poorer postoperative adaptation of speech communication.
The Results of Pharyngoesophageal Segment (PES) Vibration Analysed With the Biomechanical Model Obtained by High - Speed Video Endoscopy - Central Tendency and Dispersion - Open and Closed Phase Duration (%), Relative Shimmer and Relative Jitter
Time frame: 3 months
The development of the biomechanical model of the PES aims to quantify non-stationary pharyngoesophageal vibrations and draw conclusions about the temporal characteristics of tissue stiffness, oscillating mass, pressure, and geometric distributions within the PES. The biomechanical model identifies mathematical dependencies and analyses extracted time signals of the PES opening and contours (i.e. the opening and closing of the vibrating mucosa of the PES). The PES waveform allows calculation of relative shimmer (%), relative jitter (%), and the duration of the open and closed phases (%), or the percentage of open or closed time of the PES, which is calculated from the PES waveform using the formulas listed in reference 5.
The Results of Pharyngoesophageal Segment (PES) Vibration Analysed With the Biomechanical Model Obtained by High - Speed Video Endoscopy - Central Tendency and Dispersion - Mean Shimmer
Time frame: 3 months
The development of the biomechanical model of the PES in order to quantify non-stationary pharyngoesophageal vibrations and drawing conclusions on the temporal characteristics of tissue stiffness, oscillating mass, pressure, and geometric distributions within the PES. The biomechanical model identify mathematical dependencies and analyse extracted time signals of the PES opening and contours (i.e. the opening and closing of the vibrating mucosa of the PES). The PES waveform allowed us to calculate mean shimmer (dB).
The Results of Pharyngoesophageal Segment (PES) Vibration Analysed With the Biomechanical Model Obtained by High - Speed Video Endoscopy - Central Tendency and Dispersion of Mean Jitter
Time frame: 3 months
The development of the biomechanical model of the PES in order to quantify non-stationary pharyngoesophageal vibrations and drawing conclusions on the temporal characteristics of tissue stiffness, oscillating mass, pressure, and geometric distributions within the PES. The biomechanical model identify mathematical dependencies and analyse extracted time signals of the PES opening and contours (i.e. the opening and closing of the vibrating mucosa of the PES). The PES waveform allowed us to calculate mean jitter (s).
The Results of Pharyngoesophageal Segment (PES) Vibration Analysed With the Biomechanical Model Obtained by High - Speed Video Endoscopy - Central Tendency and Dispersion - Fundamental Frequency
Time frame: 3 months
The development of the biomechanical model of the PES in order to quantify non-stationary pharyngoesophageal vibrations and drawing conclusions on the temporal characteristics of tissue stiffness, oscillating mass, pressure, and geometric distributions within the PES. The biomechanical model identify mathematical dependencies and analyse extracted time signals of the PES opening and contours (i.e. the opening and closing of the vibrating mucosa of the PES). The PES waveform allowed us to calculate the fundamental frequency (Hz).
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Mar 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 30409318Zenga 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.
- Background: PubMed 10448737van 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.
- Background: PubMed 21558056Schwarz 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.
- Background: PubMed 24861998Huttner 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.
- Background: PubMed 29861291Schlegel 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.
- Background: PubMed 23169480Schindler 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.
- Background: PubMed 8182320Debruyne 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.
- Background: PubMed 21298450Dooks 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.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ana Đanić Hadžibegović, Assoc. Prof study chair
Clinical Hospital Centre Zagreb
Andrijana Včeva, Full Prof study chair
University Hospital Osijek
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Larynx Cancer and Laryngectomy; Status, run by Osijek University Hospital at 1 site in Croatia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 31 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Croatia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 11 Mar 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
High Speed Video Endoscopy Recordings (time frame: 15 minutes for each participants). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05561920, which also lists 8 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Mar 2026.