喉气管分离术后的气管食管发音重建
Tracheoesophageal voice restoration following laryngotracheal separation procedure.
作者信息
Shah Rahul K, Rebeiz Elie E
机构信息
Department of Otolaryngology-Head and Neck Surgery, Tufts-New England Medical Center, Boston, Massachusetts, USA.
出版信息
Ann Otol Rhinol Laryngol. 2005 Aug;114(8):634-7. doi: 10.1177/000348940511400809.
OBJECTIVES
Laryngeal dysfunction leading to incompetence and intractable aspiration can be a life-threatening problem. Laryngotracheal separation (LTS) can be used to prevent aspiration, but results in aphonia. The options for laryngeal speech following LTS are limited.
METHODS
We performed tracheoesophageal puncture (TEP) and insertion of a Blom-Singer valve in 3 patients in an attempt to restore their voice after LTS for chronic aspiration.
RESULTS
Two patients had intractable aspiration (5 and 14 years) after full-course radiotherapy for laryngeal cancer, and 1 patient had aspiration after a stroke. In the first patient TEP was done as a secondary procedure, and in the other 2 patients it was done at the time of the LTS. The TEP was successful in providing these patients with phonation ability after their LTS procedure. There was no morbidity from these procedures.
CONCLUSIONS
Creation of a TEP after an LTS procedure is relatively simple and relatively safe, and allows for the control of aspiration while maintaining vocal function.
目的
导致功能不全和顽固性误吸的喉功能障碍可能是一个危及生命的问题。喉气管分离术（LTS）可用于预防误吸，但会导致失声。LTS术后恢复喉发声的选择有限。
方法
我们对3例患者进行了气管食管穿刺（TEP）并植入Blom-Singer瓣膜，试图在LTS术后恢复其因慢性误吸导致的发声功能。
结果
2例患者在喉癌全程放疗后出现顽固性误吸（分别为5年和14年），1例患者在中风后出现误吸。第1例患者TEP作为二次手术进行，另外2例患者在LTS手术时进行TEP。TEP成功地使这些患者在LTS手术后获得了发声能力。这些手术没有引起并发症。
结论
LTS术后进行TEP相对简单且相对安全，能够在保持发声功能的同时控制误吸。
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