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[全喉切除术后使用Provox 2进行嗓音恢复]

[Provox 2 use for voice restoration after total laryngectomy].

作者信息

Kılıç Caner, Tunçel Ümit, Cömert Ela

机构信息

Department of Otolaryngology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 06200 Demetevler, Yenimahalle, Ankara, Turkey.

出版信息

Kulak Burun Bogaz Ihtis Derg. 2014 Nov-Dec;24(6):339-43. doi: 10.5606/kbbihtisas.2014.63497.

Abstract

OBJECTIVES

This study aims to determine the problems of patients applied provox 2 voice prosthesis for speech rehabilitation with their prosthesis and our treatment modalities to increase the quality of life of these patients.

PATIENTS AND METHODS

A total of 210 patients (180 males, 30 females; mean age 58±11.9 years; range 37 to 83 years) who underwent total laryngectomy, applied and changed provox 2 voice prosthesis for voice restoration were included in the study. For speech restoration of the patients with a primary (intraoperative) and secondary (postoperative) tracheoesophageal fistula was opened. In the 15th postoperative day, provox 2 voice prosthesis was placed to approximately 0.5 cm inferior and midline fistula line of the tracheostoma. The patients underwent speech exercises.

RESULTS

The mean change time of prosthesis was 7.5 months (range 1 to 48 months). Fungal colonization was detected in 141 patients (66%) who had voice prostheses. Granulation tissue developed around the voice prosthesis in 30 patients (14%), three patients (1%) swallowed their voice prosthesis, tracheoesophageal fistula width remained permanently in two patients (1%), and these patients were abandoned to use their voice prosthesis. Mediastinitis occurred in one patient (1%).

CONCLUSION

Due to several reasons such as success of high speech despite of complications and being easy to fight with these complications, provox voice prosthesis is an effective method to use for voice restoration.

摘要

目的

本研究旨在确定使用Provox 2语音假体进行言语康复的患者在使用假体过程中遇到的问题,以及我们提高这些患者生活质量的治疗方式。

患者与方法

本研究纳入了210例接受全喉切除术、使用并更换Provox 2语音假体进行语音恢复的患者(180例男性,30例女性;平均年龄58±11.9岁;年龄范围37至83岁)。对于原发性(术中)和继发性(术后)气管食管瘘的患者,进行了气管食管瘘造口术以恢复言语功能。术后第15天,在气管造口下方约0.5 cm处且位于瘘管中线放置Provox 2语音假体。患者接受了言语训练。

结果

假体的平均更换时间为7.5个月(范围1至48个月)。在141例(66%)佩戴语音假体的患者中检测到真菌定植。30例(14%)患者的语音假体周围出现肉芽组织,3例(1%)患者吞咽了语音假体,2例(1%)患者的气管食管瘘宽度永久性保持不变,这些患者放弃使用语音假体。1例(1%)患者发生纵隔炎。

结论

尽管存在并发症,但由于言语恢复效果良好且易于应对这些并发症等多种原因,Provox语音假体是一种用于语音恢复的有效方法。

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