Benazzo M, Bertino G, Lanza L, Occhini A, Mira E
Clinica Otorinolaringoiatrica, Università degli Studi di Pavia, IRCCS Policlinico S. Matteo, Italy.
Eur Arch Otorhinolaryngol. 2001 May;258(4):173-6. doi: 10.1007/s004050100324.
Speech restoration after circumferential pharyngolaryngectomy with free jejunal repair for advanced tumors of the hypopharyngo-esophageal tract remains a difficult problem to solve. We report here the results of secondary voice restoration in six patients who received a Provox 2 type prosthesis and intensive speech therapy after circumferential pharyngolaryngectomy with free jejunum repair. No patient had operative or post-operative complications due to insertion of the prosthesis. No patient had to have the prosthesis removed during the follow-up (8 to 14 months). Analysis of some acoustic parameters of voice (fundamental frequency, waveform perturbations) and qualitative characteristics of speech (intelligibility, pleasantness and acceptability) demonstrated that all the patients were able to produce satisfactory speech after tracheojejunum puncture and speech therapy and were satisfied with their own ability to communicate. Our results are reassuring and we therefore advise that in patients undergoing free jejunum flap reconstruction of the hypopharyngo-esophageal tract voice restoration should be attempted by placing a voice prosthesis through a secondary tracheo-esophageal puncture and providing intensive speech training.
对于下咽-食管段晚期肿瘤患者，采用游离空肠修复进行环周性咽喉切除术之后的言语恢复仍然是一个难以解决的问题。我们在此报告6例患者在接受环周性咽喉切除及游离空肠修复术后，植入Provox 2型假体并接受强化言语治疗后的二次言语恢复结果。没有患者因假体植入出现手术或术后并发症。在随访期间（8至14个月），没有患者需要取出假体。对一些嗓音声学参数（基频、波形扰动）和言语定性特征（可懂度、愉悦度和可接受度）的分析表明，所有患者在气管空肠穿刺和言语治疗后都能够产生令人满意的言语，并对自己的沟通能力感到满意。我们的结果令人安心，因此我们建议，对于接受下咽-食管段游离空肠瓣重建的患者，应尝试通过二次气管-食管穿刺植入语音假体并提供强化言语训练来恢复嗓音。
