Paradowska-Opałka Beata
Katedra i Klinika Otolaryngologii i Onkologii Laryngologicznej Pomorskiej Akademii Medycznej ul. Unii Lubelskiej 1, Szczecin.
Ann Acad Med Stetin. 2006;52(1):125-34; discussion 134-5.
The aim of this work was to describe the morphology of the reconstructed larynx after supracricoid horizontal laryngectomy with simultaneous cricohyopexy (CHP) or cricohyoepiglottopexy (CEHP) preserving one or both arytenoid cartilages, to study the protective and respiratory functions of the larynx, to perform phoniatric evaluation of phonation quality, to analyze voice and speech phonetic-acoustic parameters, and to search for correlations between reconstruction type and phonetic-acoustic characteristics of voice and speech.
The material comprised 58 patients (32 after CHP and 26 after CHEP).
Oval shape of the neoglottis dominated. Swallowing was normal in 46% of patients and did not depend on reconstruction type. Decannulation was possible in 66% of patients. The results were inferior after CHEP with both arytenoid cartilages intact. Socially efficient speech was found in 74% of patients and the results were better with CHEP. The phonetic-acoustic structure of voice and resonant speech was considerably different from the phonetic-acoustic structure of voice and speech under physiologic conditions. These differences applied to segmental (formant structure frequencies, noise range), as well as suprasegmental voice features.
本研究旨在描述保留一侧或双侧杓状软骨的环状软骨上水平喉切除术联合环状软骨舌骨固定术(CHP)或环状软骨舌骨会厌固定术(CEHP)后重建喉的形态,研究喉的保护和呼吸功能,对发声质量进行嗓音评估,分析语音的声学参数,以及探寻重建类型与语音的声学特征之间的相关性。
研究材料包括58例患者(32例行CHP,26例行CEHP)。
新声门呈椭圆形为主。46%的患者吞咽正常,且与重建类型无关。66%的患者可拔管。双侧杓状软骨完整的CEHP术后结果较差。74%的患者能进行有效的社交性言语交流,CEHP术后效果更佳。语音和共鸣性言语的声学结构与生理条件下语音和言语的声学结构有显著差异。这些差异适用于音段(共振峰结构频率、噪声范围)以及超音段嗓音特征。