Dragičević Danijela, Jović Rajko M, Kljajić Vladimir, Vlaški Ljiljana, Savović Slobodan
Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia,
Clinical Centre of Vojvodina, Clinic for Otorhinolaryngology and Head and Neck Surgery, Novi Sad, Serbia,
Folia Phoniatr Logop. 2020;72(5):363-369. doi: 10.1159/000502091. Epub 2019 Aug 27.
Successful speech rehabilitation has a great impact on the quality of life in totally laryngectomized patients.
The aim of this paper was to compare the self-assessed voice handicap of totally laryngectomized patients with two different methods of alaryngeal speech - esophageal (ES) and tracheoesophageal speech (TES).
The research comprised 83 totally laryngectomized, disease-free patients, split into two groups. The first group included 43 participants with successfully rehabilitated ES, and the second group included 40 participants with successfully established TES after secondary implantation of Provox 2TM voice prosthesis. All subjects filled in the Serbian version of the Voice Handicap Index (VHI-30). The results (overall score and three VHI subscales) were analyzed and compared with those of the subjects of both groups. The impact of age in the subgroups (<65 years old and ≥65 years old) and previous irradiation on the examined VHI values were also analyzed.
The median value of the overall VHI score in the participants with TES was 29.03 ± 23.479 (range: 0-97), and in the participants with ES it was 64.51 ± 21.089 (range: 19-99). The VHI scores (overall and three VHI subscales) were significantly higher in participants with ES compared to those with TES (p < 0.01), indicating a larger voice handicap. No significant difference was found in the overall VHI score and VHI subgroups in terms of age subgroups and previous irradiation (p > 0.05).
Our data reveal a significantly higher voice handicap in participants with ES compared to the TES group, with a large interindividual variation within both groups. VHI values are not significantly different between the two age subgroups, nor are they significantly influenced by irradiation.
成功的言语康复对全喉切除患者的生活质量有很大影响。
本文旨在比较全喉切除患者采用两种不同的无喉言语方式——食管发音（ES）和气管食管发音（TES）时的自我评估嗓音障碍情况。
该研究纳入了83例全喉切除且无疾病的患者，分为两组。第一组包括43例成功实现食管发音康复的参与者，第二组包括40例在二次植入Provox 2TM语音假体后成功建立气管食管发音的参与者。所有受试者填写塞尔维亚语版的嗓音障碍指数（VHI-30）。对结果（总分及三个VHI子量表）进行分析，并与两组受试者的结果进行比较。还分析了年龄亚组（<65岁和≥65岁）及既往放疗对所检测的VHI值的影响。
采用气管食管发音的参与者中VHI总分的中位数为29.03±23.479（范围：0 - 97），采用食管发音的参与者中该值为64.51±21.089（范围：19 - 99）。与采用气管食管发音的参与者相比，采用食管发音的参与者的VHI评分（总分及三个VHI子量表）显著更高（p < 0.01），表明嗓音障碍更大。在年龄亚组和既往放疗方面，VHI总分及VHI子组间未发现显著差异（p > 0.05）。
我们的数据显示，与气管食管发音组相比，食管发音参与者的嗓音障碍明显更高，且两组内个体差异较大。两个年龄亚组的VHI值无显著差异，也未受到放疗的显著影响。
