van der Torn M, de Vries M P, Festen J M, Verdonck-de Leeuw I M, Mahieu H F
Department of Otolaryngology/Head & Neck Surgery, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Laryngoscope. 2001 Feb;111(2):336-46. doi: 10.1097/00005537-200102000-00027.
To improve the voice quality of female laryngectomees and/or laryngectomees with a hypotonic pharyngoesophageal (PE) segment by means of a pneumatic artificial source of voice incorporated in a regular tracheoesophageal (TE) shunt valve.
Experimental, randomized, crossover trial.
The new sound source consists of a single silicone lip, which performs an oscillatory movement driven by expired pulmonary air flowing along the outward-striking lip through the TE shunt valve. A prototype of this pneumatic sound source is evaluated in vitro and in six laryngectomees. In vivo evaluation includes speech rate, maximal phonation time, perceptual voice evaluation of read-aloud prose by an expert listener, speech intelligibility measurements with 12 listeners, and self-assessment by the patients. Moreover, extensive acoustical and aerodynamic in vivo registrations are performed using a newly developed data acquisition system.
The current prototype seems beneficial in female laryngectomees with a hypotonic PE segment only. For them the sound-producing voice prosthesis improves voice quality and increases the average pitch of voice, without decreasing intelligibility or necessitating other pressure and airflow rates than regular TE shunt speech. Pitch regulation of this prosthetic voice is possible, yet limited.
The mechanism is feasible and does not result in unacceptable airflow resistance. For this new mechanism of alaryngeal voice to become an established technique for postlaryngectomy voice restoration, a voice suitably pitched for male laryngectomees has to be generated and a large part of the melodic and dynamic range of the sound source has to be attainable within physiological airflow rates.
通过将气动人工声源整合到常规气管食管（TE）分流阀中，改善女性喉切除患者和/或咽食管（PE）段张力减退的喉切除患者的嗓音质量。
实验性、随机、交叉试验。
新声源由单个硅胶唇组成，该硅胶唇通过TE分流阀，在沿向外撞击唇部流动的呼出肺气流驱动下进行振荡运动。对该气动声源的原型进行体外评估，并在6名喉切除患者中进行评估。体内评估包括语速、最大发声时间、专业听众对朗读散文的嗓音感知评估、12名听众的言语可懂度测量以及患者的自我评估。此外，使用新开发的数据采集系统进行广泛的体内声学和空气动力学记录。
目前的原型似乎仅对PE段张力减退的女性喉切除患者有益。对于她们来说，发声语音假体可改善嗓音质量并提高平均音高，而不会降低可懂度，也不需要与常规TE分流言语不同的其他压力和气流速率。这种假体嗓音的音高调节是可行的，但有限。
该机制是可行的，不会导致不可接受的气流阻力。为使这种新的无喉嗓音机制成为喉切除术后嗓音恢复的既定技术，必须产生适合男性喉切除患者的嗓音，并且必须在生理气流速率范围内实现声源大部分的旋律和动态范围。
