Multiparametric studies of voice and speech after laser endoscopic cordectomy of types II-III
This thesis concerns the study of the phonetic characteristics of the voice and speech after laser cordectomy of types II-III, proposed for laryngeal tumors limited to the vocal fold. Cordectomies of types II-III consist of resection of the epithelium, vocal ligament, lamina propria and a variable part of the vocal muscle. This new anatomicophysiological configuration creates an apposition of the vocal folds less effective and a vibratory asymetry, which involve perturbations in frequency and amplitude and a possible alteration of the voicing. This is a prospective study of 10 male French patients aged 47-80 years. The subjects were recorded between 6 months and 1 year postoperatively. A healthy population of 10 males, aged 34-67 years was the control group. The first chapter is an anatomical and biomechanical reminder of the phonation. It provides a better understand of the mechanisms of voice production and speech. The second chapter is a brief presentation of partial laryngeal surgeries. It allows us to determine, in particular, the emergence of laser cordectomies. The third chapter is a description of the different laser cordectomies. We also present a review of the literature which shows the functional results after these surgeries, but also emphasizes on the multiparamétric dimension of the scientific approaches. The fourth chapter is a detailed description of the populations studied, the corpus and the materials used for our various studies. The fifth chapter includes four studies which show the impact of surgery on the parameters of the F0, loudness and their perturbation factors (jitter and shimmer). The ranges of variation of F0 of the subjects will be analyzed. The last chapter is devoted to the implementation of the voicing feature. It consists of four studies (acoustic, aerodynamic, EGG and perceptual) which will allow us to observe the preservation of voicing contrast of plosives after these cordectomies.