Kosztyła-Hojna Bozena, Rogowski Marek, Łuczaj Jarosław, Kasperuk Joanna
Uniwersytet Medyczny w Białymstoku, Klinika Otolaryngologii.
Pol Merkur Lekarski. 2008 Sep;25(147):230-5.
Voice rehabilitation with the application of voice prostheses is a method of choice in surgical rehabilitation of patients following total laryngectomy.
To compare voice quality and fistula speech with use of second generation voice prostheses to voice and esophageal speech in patients rehabilitated with vocal method.
The following study comprised 37 patients with fistula speech (group I). The assessment of voice quality included subjective and objective examination and acoustic analysis of fistula speech and aesophageal. Examination results were compared with data obtained in 15 patients with oesophageal voice of similar age and gender composition (group II). The acoustic analysis was performed using IRIS Medicom software. Fo values and Jitter, Shimmer, HNR parameters were analysed.
All examined patients with fistula speech demonstrated a permanent capacity of speaking, which enabled efficient verbal communication. Average values obtained during 'perception test' located this type of phonation between good and very good speech. Formant recordings in narrow-band spectrographs indicated relatively normal supraglottal articulation which is a factor conditioning good speech comprehension. During subjective assessment, fistula voice and speech were moderately loud, dull, hoarse, uttered in unrestrained, breathed way rather than being forced. Persistence of the pathologic phonation was confirmed by acoustic voice evaluation parameters (Jitter, Shimmer, HNR and Fo).
Examination findings confirm better voice quality obtained in rehabilitation with second generation voice prostheses as compared to oesophageal voice and speech resulting from natural rehabilitation process.
应用语音假体进行嗓音康复是全喉切除术后患者外科康复的一种首选方法。
比较使用第二代语音假体进行嗓音康复的患者的嗓音质量和瘘管语音与采用发声方法康复的患者的嗓音和食管语音。
以下研究纳入了37例有瘘管语音的患者(第一组)。嗓音质量评估包括主观和客观检查以及瘘管语音和食管语音的声学分析。将检查结果与15例年龄和性别构成相似的食管发音患者(第二组)的数据进行比较。使用IRIS Medicom软件进行声学分析。分析了基频(Fo)值以及抖动、闪烁、谐噪比(HNR)参数。
所有接受检查的有瘘管语音的患者均表现出持续的说话能力,这使得有效的言语交流成为可能。在“感知测试”中获得的平均值表明这种发声类型介于良好语音和非常良好语音之间。窄带频谱图中的共振峰记录表明声门上发音相对正常,这是良好言语理解的一个影响因素。在主观评估中,瘘管嗓音和语音音量适中、沉闷、嘶哑,以不受限制的、带呼吸声的方式发出,而非用力发声。声学嗓音评估参数(抖动、闪烁、谐噪比和基频)证实了病理性发声的持续存在。
检查结果证实,与食管语音以及自然康复过程产生的语音相比,使用第二代语音假体进行康复可获得更好的嗓音质量。