Baugh R F, Lewin J S, Baker S R
Division of Otolaryngology--Head and Neck Surgery, Scott and White Memorial Hospital, Temple, Texas 76508.
Head Neck. 1990 Jan-Feb;12(1):69-73. doi: 10.1002/hed.2880120110.
Twenty-three tracheoesophageal speech failures were prospectively evaluated by clinical parameters and transnasal air insufflation at 3 L per minute. The results of testing allow an accurate indication of the etiology of the speech failure. Pharyngoesophageal spasm accounted for 79% of the failures; hypopharyngeal strictures for 26%. One patient was found to have both pharyngoesophageal spasm and a hypopharyngeal stricture. A modified air insufflation test result greater than 20 mm Hg reliably identified all tracheoesophageal speech failures prior to tracheoesophageal puncture. Clinical parameters were not helpful in identifying speech failures. Successful treatment of the specific etiology of the failure resulted in a reduction of the measured intraesophageal pressures. Ninety-one percent of the tracheoesophageal speech failures were successfully rehabilitated and achieved fluent tracheoesophageal speech. Successful rehabilitation was associated with long-term tracheoesophageal speech use.
对23例气管食管语音失败患者进行了前瞻性评估，采用临床参数和每分钟3升的经鼻吹气法。测试结果能够准确显示语音失败的病因。咽食管痉挛占失败病例的79%；下咽狭窄占26%。发现1例患者同时存在咽食管痉挛和下咽狭窄。在气管食管穿刺前，改良吹气试验结果大于20毫米汞柱可可靠地识别所有气管食管语音失败病例。临床参数对识别语音失败并无帮助。针对失败的具体病因进行成功治疗后，可使测得的食管内压力降低。91%的气管食管语音失败患者成功康复并实现了流畅的气管食管语音。成功康复与长期使用气管食管语音有关。
