Hirano M
Dept. of Otolaryngology-Head and Neck Surgery, Kurume University.
Gan To Kagaku Ryoho. 1990 Apr;17(4 Pt 2):795-801.
This paper describes recent advances in surgical and behavioral rehabilitation for voice, speech and swallowing disorders caused by surgeries for head and neck cancer. Voice disorders result from total laryngectomy, partial laryngectomy and vocal fold laser surgery. Voice prostheses have been recently employed as one of the choices for laryngectomized patients. Surgical reconstruction and voice therapy are the modalities for voice disorders following partial laryngectomy. Dysphonia caused by laser surgery is treated by means of voice therapy. Speech disorders occur following extensive surgery for cancers of the oral cavity and oropharynx. Reconstructive surgery and speech therapy are the modalities to be employed. Swallowing problems are caused by supraglottic horizontal laryngectomy, partial laryngopharyngectomy, extensive surgery for cancers of the oral cavity and oropharynx, surgery for parotid gland and skin cancers associated with a section of the vagus nerve and surgery for esophageal cancers. Surgical treatment and swallow therapy are employed. Surgical treatment is divided into five groups: surgery for velopharyngeal incompetence, those for glottic incompetence, laryngeal suspension surgery, narrowing surgery of the pharynx and cricopharyngeal myotomy. Some cases are described for each treatment modality.
本文描述了针对头颈癌手术所致嗓音、言语和吞咽障碍的外科及行为康复方面的最新进展。嗓音障碍由全喉切除术、部分喉切除术和声带激光手术引起。嗓音假体最近已成为喉切除患者的选择之一。手术重建和嗓音治疗是部分喉切除术后嗓音障碍的治疗方式。激光手术所致的发声障碍通过嗓音治疗来处理。言语障碍发生在口腔和口咽癌的广泛手术后。重建手术和言语治疗是所采用的治疗方式。吞咽问题由声门上水平喉切除术、部分喉咽切除术、口腔和口咽癌的广泛手术、腮腺和皮肤癌手术（伴有迷走神经部分切除）以及食管癌手术引起。采用手术治疗和吞咽治疗。手术治疗分为五组：腭咽闭合不全手术、声门闭合不全手术、喉悬吊手术、咽部狭窄手术和环咽肌切开术。每种治疗方式都描述了一些病例。
