Wei Xudong, Jin Guowei, Jun Wang, Zhang Jianxin, Gao Xiaoling
Department of Otolaryngology-Head and Neck Surgery, People's Hospital of GanSu Province, 160 DongGangXiLu Road, lanzhou, China.
Acta Otolaryngol. 2011 May;131(5):539-45. doi: 10.3109/00016489.2010.535849. Epub 2010 Dec 20.
The slit-like trachea-esophagus puncture is a reliable procedure to restore the voice in the patient who has undergone a total laryngectomy. The new voice quality could be similar to normal and could meet the patient's daily needs.
We report a new method of tracheoneoesophageal (TE) voice rehabilitation. A slit-like trachea-esophagus puncture was made in the tracheoesophageal wall after the total laryngectomy. No voice prosthesis was used. The purpose of this study was to observe its aerodynamic characteristics.
All 60 patients received voice rehabilitation with the slit-like fistula after total laryngectomy. All patients' voices were evaluated as excellent. The aerodynamic characteristics of trachea-esophagus voices were observed.
When a patient attempted to phonate, the upper esophagus was closed. Then, the hypopharyngeal cavity expanded. Just before phonating, the upper esophagus was full of air as a ball. The air flow escaped through the segment of the trachea-esophagus slit and entered the pharyngoesophageal segment (PES). The esophageal meatus opened. It was vibrated together with nearby mucus and mucosa to form the voice. The maximum phonation time of the slit-like fistula voice was not significantly different from the Blom-Singer prosthesis voice. Its sound intensity was similar to the normal voice.
对于接受全喉切除术的患者，裂隙状气管食管穿刺是一种恢复发声的可靠方法。新的嗓音质量可接近正常，能满足患者日常需求。
我们报告一种新的气管食管（TE）发声重建方法。在全喉切除术后，于气管食管壁制作裂隙状气管食管穿刺。未使用发音钮。本研究的目的是观察其空气动力学特征。
60例患者在全喉切除术后均采用裂隙状瘘管进行发声重建。所有患者的嗓音评估均为优秀。观察气管食管发音的空气动力学特征。
患者试图发声时，食管上段关闭。随后，下咽腔扩张。就在发声前，食管上段充满空气呈球状。气流通过气管食管裂隙段逸出，进入咽食管段（PES）。食管口张开。它与附近的黏液和黏膜一起振动形成声音。裂隙状瘘管发声的最长发声时间与Blom-Singer发音钮发声无显著差异。其声强与正常嗓音相似。
