Takatsu Jun, Hanai Nobuhiro, Suzuki Hidenori, Yoshida Masahiro, Tanaka Yasuhiro, Tanaka Seiya, Hasegawa Yasuhisa, Yamamoto Masahiko
SLHT, Department of Rehabilitation, Aichi Cancer Center Hospital, Aichi; PhD Student, Department of Speech Pathology, Aichi-Gakuin University, Aichi, Japan.
Medical Director, Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Aichi, Japan.
J Oral Maxillofac Surg. 2017 Jul;75(7):1530-1541. doi: 10.1016/j.joms.2016.12.004. Epub 2016 Dec 11.
Changes in acoustic features in the perioperative phase for elucidating the mechanisms of articulation disorder and the effect of perioperative rehabilitation were studied prospectively.
Sixty-two patients with 62 tongue cancer were divided into a partial glossectomy group (n = 40) and a reconstruction group (n = 22). Acoustic characteristics were analyzed during the preoperative and postoperative periods and after rehabilitation using the first and second formants of the vowels /a/, /i/, and /u/; the triangular vowel space area (tVSA); and the slopes of formant transitions.
In the 2 groups, decreases in the tVSA and formant slopes were found from the preoperative to the postoperative period, and the acoustic characteristics of the reconstruction group especially improved to preoperative values after rehabilitation. Analysis of the postoperative period showed that acoustic characteristics were altered at the site of surgical resection.
Changes of acoustic variables are related to excision size and site, suggesting the distinctive tongue portion for the articulation of each speech sound. Perioperative rehabilitation could activate the articulators and increase the range of movement of the remaining tongue, especially the preserved anterior tongue.
前瞻性研究围手术期声学特征的变化,以阐明构音障碍的机制及围手术期康复的效果。
62例舌癌患者分为部分舌切除术组(n = 40)和重建组(n = 22)。在术前、术后及康复后,利用元音/a/、/i/和/u/的第一和第二共振峰、三角元音空间面积(tVSA)以及共振峰过渡斜率分析声学特征。
两组患者从术前到术后tVSA和共振峰斜率均降低,重建组康复后的声学特征尤其改善至术前水平。术后分析表明,手术切除部位的声学特征发生了改变。
声学变量的变化与切除大小和部位有关,提示每个语音发音的舌部不同区域。围手术期康复可激活发音器官,增加剩余舌部,尤其是保留的前舌的活动范围。