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舌癌切除术后患者腭部增高后的语音评估

Speech evaluation after palatal augmentation in patients undergoing glossectomy.

作者信息

de Carvalho-Teles Viviane, Sennes Luiz Ubirajara, Gielow Ingrid

机构信息

Rehabilitation Department, Fundação Oncocentro de São Paulo, 2396, Oscar Freire, São Paulo, Brazil 05409-012.

出版信息

Arch Otolaryngol Head Neck Surg. 2008 Oct;134(10):1066-70. doi: 10.1001/archotol.134.10.1066.

Abstract

OBJECTIVE

To assess, in patients undergoing glossectomy, the influence of the palatal augmentation prosthesis on the speech intelligibility and acoustic spectrographic characteristics of the formants of oral vowels in Brazilian Portuguese, specifically the first 3 formants (F1 [/a,e,u/], F2 [/o,ó,u/], and F3 [/a,ó/]).

DESIGN

Speech evaluation with and without a palatal augmentation prosthesis using blinded randomized listener judgments.

SETTING

Tertiary referral center.

PATIENTS

Thirty-six patients (33 men and 3 women) aged 30 to 80 (mean [SD], 53.9 [10.5]) years underwent glossectomy (14, total glossectomy; 12, total glossectomy and partial mandibulectomy; 6, hemiglossectomy; and 4, subtotal glossectomy) with use of the augmentation prosthesis for at least 3 months before inclusion in the study.

MAIN OUTCOME MEASURES

Spontaneous speech intelligibility (assessed by expert listeners using a 4-category scale) and spectrographic formants assessment.

RESULTS

We found a statistically significant improvement of spontaneous speech intelligibility and the average number of correctly identified syllables with the use of the prosthesis (P < .05). Statistically significant differences occurred for the F1 values of the vowels /a,e,u/; for F2 values, there was a significant difference of the vowels /o,ó,u/; and for F3 values, there was a significant difference of the vowels /a,ó/ (P < .001).

CONCLUSIONS

The palatal augmentation prosthesis improved the intelligibility of spontaneous speech and syllables for patients who underwent glossectomy. It also increased the F2 and F3 values for all vowels and the F1 values for the vowels /o,ó,u/. This effect brought the values of many vowel formants closer to normal.

摘要

目的

评估在接受舌切除术的患者中,腭部增高假体对巴西葡萄牙语中口腔元音共振峰的语音清晰度和声学频谱特征的影响,特别是前三个共振峰(F1[/a,e,u/]、F2[/o,ó,u/]和F3[/a,ó/])。

设计

使用盲法随机听众判断,在佩戴和不佩戴腭部增高假体的情况下进行语音评估。

地点

三级转诊中心。

患者

36例患者(33名男性和3名女性),年龄30至80岁(平均[标准差],53.9[10.5]岁),接受了舌切除术(14例全舌切除术;12例全舌切除术和部分下颌骨切除术;6例半舌切除术;4例次全舌切除术),在纳入研究前使用增高假体至少3个月。

主要观察指标

自发语音清晰度(由专业听众使用4级量表评估)和频谱共振峰评估。

结果

我们发现,使用假体后,自发语音清晰度和正确识别音节的平均数量有统计学意义的改善(P<.05)。元音/a,e,u/的F1值存在统计学显著差异;对于F2值,元音/o,ó,u/存在显著差异;对于F3值,元音/a,ó/存在显著差异(P<.001)。

结论

腭部增高假体提高了接受舌切除术患者的自发语音和音节清晰度。它还增加了所有元音的F2和F3值以及元音/o,ó,u/的F1值。这种效果使许多元音共振峰的值更接近正常。

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