Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, INF 400, D-69120, Heidelberg, Germany.
Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, INF 400, D-69120, Heidelberg, Germany.
J Craniomaxillofac Surg. 2018 Nov;46(11):1924-1933. doi: 10.1016/j.jcms.2018.09.017. Epub 2018 Sep 21.
Quality of life in tumour patients following combined ablative and reconstructive head and neck surgery varies significantly. This is at least partially due to differences in speech and swallowing function. A tool to objectively evaluate articulation by magnetic resonance imaging (MRI) has now been tested alongside ultrasound examination.
A standardized sequence of phonemes from the German language was established in 20 healthy volunteers and recorded in different planes by MRI and ultrasound. Phonemes were identified through recognition of typical tongue configurations by two different observers. An algorithm for metric analysis of articulation in terms of distances and angles for five extreme points on the tongue (anterior, posterior, cranial and two basal corners) was designed. The findings in these volunteers were subsequently compared with the results of an examination of a tumour patient.
Physiological articulation was visualized and evaluated both by MRI and ultrasound. There was a high intra-class correlation coefficient for measurements between independent observers. Tongue position for certain phonemes was mostly constant in healthy patients of different age groups, with gender-specific differences. In a first comparison, tongue position in a patient with tongue cancer differed significantly from this position, both pre- and postoperatively. In agreement with clinical articulation quality, the tongue position of the patient returned to almost normal within 12 months postoperatively.
Both ultrasound and MRI are appropriate instruments for visualization of articulation and objective measurements to evaluate speech in tumour patients. Whilst MRI is more precise and can identify more subtle differences, ultrasound is a valid alternative due to its wider availability and broader applicability.
接受联合消融和重建头颈部手术的肿瘤患者的生活质量差异很大。这至少部分是由于言语和吞咽功能的差异。现在已经测试了一种通过磁共振成像（MRI）客观评估发音的工具，同时还进行了超声检查。
在 20 名健康志愿者中建立了一套标准化的德语语音序列，并通过 MRI 和超声在不同平面进行记录。通过两位不同观察者识别典型的舌位来识别语音。设计了一种用于测量舌头上五个极值点（前、后、颅顶和两个基角）的距离和角度的发音度量分析算法。随后将这些志愿者的发现与肿瘤患者检查的结果进行比较。
MRI 和超声均可对生理发音进行可视化和评估。独立观察者之间的测量值具有很高的组内相关系数。对于不同年龄组的健康患者，某些语音的舌位基本保持不变，但存在性别差异。在第一次比较中，舌癌患者的舌位与术前和术后均存在显著差异。与临床发音质量一致，患者的舌位在术后 12 个月内几乎恢复正常。
超声和 MRI 都是评估肿瘤患者言语的发音可视化和客观测量的合适工具。虽然 MRI 更精确，可以识别更细微的差异，但由于其更广泛的可用性和适用性，超声是一种有效的替代方法。
