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接受扩大气管上喉切除术患者的吞咽、嗓音及生活质量

Swallowing, voice and quality of life of patients submitted to extended supratracheal laryngectomy.

作者信息

Zica Guilherme Maia, Freitas Andressa Silva de, Silva Ana Catarina Alves E, Dias Fernando Luiz, Santos Izabella Costa, Freitas Emilson Queiroz, Koch Hilton Augusto

机构信息

Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brazil.

Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.

出版信息

Einstein (Sao Paulo). 2020;18:eAO5390. doi: 10.31744/einstein_journal/2020ao5390. Epub 2020 May 18.

Abstract

Objective To describe functional and quality of life results after extended supratracheal laryngectomy. Methods In the period from September 2009 to January 2018, 11 male subjects were submitted to extended supratracheal laryngectomy. Swallowing abilities were assessed through videofluoroscopy and the clinical scale Functional Communication Measures of Swallowing. The voices were classified by means of the perceptual-auditory analysis Consensus Auditory-Perceptual Evaluation of Voice. All subjects completed a self-assessment questionnaire for voice and swallowing. Results Aspiration was found in four patients and all presented stasis in different structures. All subjects in this study were exclusively orally fed and hydrated. In the evaluation of quality of life in swallowing, patients had mean >80 in all areas (83.47 mean of scores). The general degree and the presence of roughness were the highest means present in Consensus Auditory-Perceptual Evaluation of Voice (37.81 and 49.36, respectively). The mean of 33.36 (±22.56) had little impact on quality of life under the perspective of vocal aspects. Conclusion After supratracheal laryngectomy, swallowing was sufficiently restored and the quality of life was satisfactory. The voice presents severely impaired quality and preserved oral communication, with low impact on the activities of daily living. All individuals who maintained two cricoarytenoid units presented better functional results in swallowing and voice.

摘要

目的 描述扩大气管上喉切除术后的功能及生活质量结果。方法 在2009年9月至2018年1月期间,11名男性受试者接受了扩大气管上喉切除术。通过电视荧光吞咽造影和吞咽功能交流临床量表评估吞咽能力。通过嗓音听觉感知分析(嗓音共识听觉-感知评估)对嗓音进行分类。所有受试者均完成了嗓音和吞咽自我评估问卷。结果 4例患者存在误吸,且均在不同结构出现滞留。本研究中所有受试者均仅经口进食和补水。在吞咽生活质量评估中,患者在所有领域的平均得分>80(平均得分83.47)。在嗓音共识听觉-感知评估中,总体程度和粗糙程度的平均分最高(分别为37.81和49.36)。从嗓音方面来看,平均33.36(±22.56)对生活质量影响较小。结论 气管上喉切除术后,吞咽功能得到充分恢复,生活质量令人满意。嗓音质量严重受损,但保留了经口交流能力,对日常生活活动影响较小。所有保留两个环状杓状软骨单元的个体在吞咽和嗓音方面均表现出更好的功能结果。

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