Schindler Antonio, Fantini Marco, Pizzorni Nicole, Crosetti Erika, Mozzanica Francesco, Bertolin Andy, Ottaviani Francesco, Rizzotto Giuseppe, Succo Giovanni
Department of Biomedical and Clinical Sciences "L. Sacco,", University of Milan, Milan, Italy.
Head Neck. 2015 Apr;37(4):557-66. doi: 10.1002/hed.23636. Epub 2014 Apr 10.
The purpose of this study was to report preliminary long-term outcomes after supratracheal laryngectomy (STL).
Twenty-two male patients who underwent STL were involved in this study. Swallowing skills, neoglottis motility, and vibrations were videoendoscopically assessed. Aerodynamic measures, spectrogram analysis, aspiration pneumonia, body weight variations, and voice perceptual assessment were performed. Generic, voice-related, and swallowing-related quality of life (QOL) were assessed.
Aspiration was found in 10, 2, and 5 patients, respectively, for liquids, semisolids, and solids. Neoglottis motility was generally preserved, whereas vibration was impaired. Aerodynamic measures showed a poor performance. Perceptual assessment revealed highly dysphonic voices. In only 8 patients, a harmonic structure was visible in the spectrograms. Aspiration pneumonia occurred in 2 patients. Preoperative weight was maintained in 16 patients. Generic, voice-related, and swallowing-related QOL revealed satisfied patients.
After STL, swallowing was sufficiently restored and QOL was satisfactory, whereas the voice was severely impaired even if oral communication was well preserved.
本研究的目的是报告气管上喉切除术（STL）后的初步长期结果。
本研究纳入了22例行STL的男性患者。通过视频内镜评估吞咽技能、新声门运动和振动情况。进行了空气动力学测量、频谱分析、吸入性肺炎、体重变化及嗓音感知评估。评估了一般生活质量、嗓音相关生活质量和吞咽相关生活质量（QOL）。
分别在10例、2例和5例患者中发现液体、半固体和固体食物存在误吸。新声门运动一般得以保留，而振动功能受损。空气动力学测量结果不佳。感知评估显示嗓音严重发音障碍。仅8例患者的频谱图中可见谐波结构。2例患者发生吸入性肺炎。16例患者维持了术前体重。一般生活质量、嗓音相关生活质量和吞咽相关生活质量显示患者满意度较高。
STL术后，吞咽功能得到充分恢复，生活质量令人满意，然而即使口语交流保存良好，嗓音仍严重受损。
