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全喉切除术后食管发音患者食管内空气动力学及食管括约肌的研究

Investigation of intra-esophageal air kinetics and esophageal sphincters in patients with total laryngectomy during esophageal speech.

作者信息

Bozan Aykut, Vardar Rukiye, Akyildiz Serdar, Kirazli Tayfun, Ogut Fatih, Yildirim Esra, Bor Serhat

机构信息

Department of Otolaryngology, Ege Reflux Study Group, Ege University School of Medicine, 35040, Izmir, Turkey,

出版信息

Eur Arch Otorhinolaryngol. 2015 Aug;272(8):1967-72. doi: 10.1007/s00405-015-3600-2. Epub 2015 Mar 13.

Abstract

The purpose of this study was to evaluate the air kinetics of well- and poor-speaking patients and their upper (UES) and lower (LES) esophageal sphincter pressures . The esophageal speech capability of 23 total laryngectomy patients was assessed with the Wepman scale. LES and UES points and pressures were measured, and air kinetics were compared. All patients were male, with an average age of 58 years. Both the LES and UES pressures were not statistically different between good-speaking and poor-speaking patients (p > 0.05). The ability to speak was estimated only by looking at tracings. Good speakers are able to retain air successfully and on a long-term basis between the upper and lower esophageal sphincters. During short and/or rapid speech, these patients are able to rapidly suck and then expel the air from their upper esophagus. During long speeches, after sucking the air into their distal esophagus, they used the air in the upper part of the esophagus during the speech, only later seeming to fill the lower esophagus with the air as a possible reserve in the stomach. It has been shown that the basic requirement for speaking is the capacity to suck and store the air within the esophagus. For successful speech, the air should be stored inside the esophagus. MII technology contributes to our understanding of speech kinetics and occupies an important place in patient training as a biofeedback technique.

摘要

本研究的目的是评估言语能力良好和较差的患者的空气动力学以及他们的上食管括约肌(UES)和下食管括约肌(LES)压力。采用韦普曼量表评估23例全喉切除术患者的食管言语能力。测量LES和UES的点数及压力,并比较空气动力学情况。所有患者均为男性,平均年龄58岁。言语能力良好和较差的患者之间,LES和UES压力均无统计学差异(p>0.05)。仅通过观察描记图来评估言语能力。言语能力良好的患者能够成功且长期地在上、下食管括约肌之间保留空气。在短时间和/或快速言语过程中,这些患者能够迅速吸入然后从食管上部排出空气。在长时间言语过程中,将空气吸入食管远端后,他们在言语过程中使用食管上部的空气,之后才似乎将空气填充到食管下部作为胃中的可能储备。研究表明,言语的基本要求是在食管内吸入和储存空气的能力。为了成功言语,空气应储存在食管内。多通道腔内阻抗技术有助于我们理解言语动力学,并且作为一种生物反馈技术在患者训练中占据重要地位。

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