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[全喉切除术后植入人工喉瓣膜患者的语音康复结果]

[Results of rehabilitation of voice and speeches after implantation of valve vocal prosthesis at ill after total removal of larynx].

作者信息

Ratajczak Jan, Wojdas Andrzej, Jurkiewicz Dariusz

机构信息

Klinika Otolaryngologii CSK MON, Wojskowego Instytutu Medycznego w Warszawie.

出版信息

Otolaryngol Pol. 2008;62(6):727-30. doi: 10.1016/S0030-6657(08)70348-2.

Abstract

Ill applying with extensive infiltration of new-growth within of larynx will demand radical therapeutic procedure, which is operation completely removals of organ. Aim of work was estimation of voice and speeches ill with vocal fistula in comparison with oesophageal voice and speech and with physiological. With research one embraced 81 men in age 42-75 of years. Group I--32 ill with cancer of larynx, to which executed total laryngectomy and placed the voice prosthesis Provox 2. Group II--30 ill after operation total removals of larynx, whiches used oesophageal speech. The control group III--19 persons with physiological voice. Research one began from subjective estimation of replacement voices. Then one executed measurements maximum phonation time of vowel "a". To objective estimation of voice one used polish programme "IRIS". One compared: maximum intensities of voices for colloquial speech, F0, Jitter, Shimmer and NHR. In subjective estimation voice of the patients with voice prostheses was greater freedom of production and voice of the patients with voice prostheses appeared to be more loud in relation to oesophageal voice. Greatest statistical essential differences one obtained between maximum phonation times of vowels "a" where clearly is visible, that values obtained for voices of the patients with voice prostheses are to nearer values for physiological voices. Obtained averages values of acoustic analysis: F0, Jitter, Shimmer and NHR did not show statistical of essential differences between voices supplementary, though parameters of voice of the patients with voice prostheses one was to nearer parameters of physiological voice. Characterization perceptive and acoustic speech of the patients with voice prostheses in comparison with oesophageal speech is to nearer characterization of physiological speech. Lack of satisfactory effects of rehabilitation of oesophageal speech, should be effective secondary implantation vocal prosthesis.

摘要

喉部广泛浸润新生物的疾病需要采取根治性治疗手段,即完全切除器官的手术。本研究的目的是评估声带瘘患者的嗓音和言语,并与食管发音及正常生理嗓音进行比较。研究纳入了81名年龄在42至75岁之间的男性。第一组——32例喉癌患者,接受了全喉切除术并植入了Provox 2型语音假体。第二组——30例喉全切除术后患者,采用食管发音。对照组第三组——19名具有正常生理嗓音的人。研究首先从对替代嗓音的主观评估开始。然后测量元音“a”的最大发声时间。为了对嗓音进行客观评估,使用了波兰的“IRIS”程序。比较了:日常言语的嗓音最大强度、F0、抖动、闪烁和噪声谐波比值。在主观评估中,使用语音假体的患者的嗓音产生更自由,与食管发音相比,使用语音假体的患者的嗓音似乎更大声。在元音“a”的最大发声时间之间获得了最大的统计学显著差异,很明显可以看出,使用语音假体的患者的嗓音所获得的值更接近生理嗓音的值。获得的声学分析平均值:F0、抖动、闪烁和噪声谐波比值在补充嗓音之间没有显示出统计学上的显著差异,尽管使用语音假体的患者的嗓音参数更接近生理嗓音参数。与食管发音相比,使用语音假体的患者的感知和声学言语特征更接近生理言语特征。食管发音康复效果不理想,应进行有效的二期声带假体植入。

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