Arenaz Búa Beatriz, Olsson Rolf, Westin Ulla, Rydell Roland
1 Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö and Lund, Sweden.
Ann Otol Rhinol Laryngol. 2017 Feb;126(2):138-145. doi: 10.1177/0003489416681321. Epub 2016 Dec 8.
The aim of the present study was to characterize the pharyngoesophageal segment in laryngectomees who rated themselves as functional tracheoesophageal speakers.
Voice perceptual assessment, high-resolution videomanometry of swallowing and phonation, and high-speed camera recording during phonation provided information about the anatomy and function of the pharyngoesophageal segment.
Fourteen patients were included in the study. The voice assessments presented high intra/inter-listener reliability. We found a significant correlation between roughness and poor voice quality, hyperfunction and poor intelligibility, and poor voice quality, long time since the operation, and old age. High-resolution videomanometry during phonation revealed decreasing mean pressures from the distal esophagus to the pharynx and confirmed low resting pressures at the pharyngoesophageal segment and low esophageal peristaltic contraction pressures after laryngectomy in comparison to normal subjects. The neoglottis shape was mainly circular and presented a strong mucosal wave in most of the patients on the high-speed camera recording.
Perceptual voice assessment and high-speed camera recordings provided baseline information about voice characteristics and vibration regularity of the neoglottis. Additionally, the quantitative measures obtained with high-resolution videomanometry may have clinical applicability as reference data in voice rehabilitation after total laryngectomy.
本研究旨在对自我评估为功能性气管食管发音者的喉切除患者的咽食管段进行特征描述。
嗓音感知评估、吞咽和发声的高分辨率测压法以及发声时的高速摄像记录提供了有关咽食管段解剖结构和功能的信息。
14例患者纳入研究。嗓音评估显示在不同听众间具有较高的可靠性。我们发现粗糙度与嗓音质量差、功能亢进与清晰度差、嗓音质量差、术后时间长以及年龄大之间存在显著相关性。发声时的高分辨率测压显示从食管远端到咽部平均压力降低，并证实与正常受试者相比，喉切除术后咽食管段静息压力低以及食管蠕动收缩压力低。新声门形状主要为圆形，在大多数患者的高速摄像记录中呈现强烈的黏膜波。
嗓音感知评估和高速摄像记录提供了有关新声门嗓音特征和振动规律的基线信息。此外，通过高分辨率测压获得的定量测量结果可能具有临床适用性，可作为全喉切除术后嗓音康复的参考数据。
