Department of Otorhinolaryngology, Head and Neck Surgery, United Christian Hospital, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong.
Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Laryngoscope. 2021 May;131(5):E1616-E1623. doi: 10.1002/lary.29298. Epub 2020 Dec 2.
OBJECTIVES/HYPOTHESIS: To evaluate the voice and speech outcomes after tubed supraglottic laryngeal closure (TSLC) surgery to treat chronic aspiration after radiotherapy for head and neck cancer.
A retrospective case-control study.
The data of patients who underwent radiotherapy for head and neck cancer and who later required total laryngectomy or TSLC for chronic aspiration between 2004 and 2017 were retrieved from a dysphagia clinic. Preoperative and postoperative voice and speech were assessed by the GRBAS and INFVo rating scales. Control subjects who underwent radiotherapy alone or total laryngectomy with a tracheoesophageal prosthesis for other indications were recruited for comparison.
Of 15 patients who underwent a TSLC with a mean age of 57.3 years (45-75 years), 13 were male and 2 female. All patients had a history of nasopharyngeal carcinoma. The success rate of speech production using their own larynx following an intact TSLC was 64%. There was no statistically significant difference in voice and speech ratings between preoperative and TSLC subjects on the GRBAS (P = .32) and INFVo scales (P = .57), although the quality of voice appeared to deteriorate after TSLC. However, the INFVo scale for impression, intelligibility and unsteadiness of the voice after TSLC was statistically significantly better than for laryngectomy with tracheoesophageal speech.
A tubed supraglottic laryngeal closure controls chronic aspiration while preserving the larynx for phonation, and results in a better voice and speech quality than a laryngectomy with a voice prosthesis.
4 Laryngoscope, 131:E1616-E1623, 2021.
目的/假设：评估因头颈部癌症放疗后慢性误吸而行管状声门上喉闭合（TSLC）手术后的嗓音和言语结局。
回顾性病例对照研究。
从吞咽困难诊所中检索了 2004 年至 2017 年间因头颈部癌症接受放疗且随后因慢性误吸而需要全喉切除术或 TSLC 的患者的数据。术前和术后的嗓音和言语通过 GRBAS 和 INFVo 评分量表进行评估。招募了因其他原因接受单纯放疗或全喉切除术加气管食管假体的对照受试者进行比较。
15 例行 TSLC 的患者平均年龄为 57.3 岁（45-75 岁），13 例为男性，2 例为女性。所有患者均有鼻咽癌病史。在完整的 TSLC 后，使用自身喉部进行言语产生的成功率为 64%。在 GRBAS（P =.32）和 INFVo 量表（P =.57）上，TSLC 术前和术后患者的嗓音和言语评分无统计学差异，尽管 TSLC 后嗓音质量似乎恶化。然而，TSLC 后嗓音的印象、可理解性和不稳定性的 INFVo 量表评分明显优于全喉切除术加气管食管语。
管状声门上喉闭合术可控制慢性误吸，同时保留喉用于发声，并产生比带嗓音假体的全喉切除术更好的嗓音和言语质量。
4 级喉镜，131：E1616-E1623，2021 年。
