Graduate Program in Dentistry at the Federal University of Pernambuco, Health Sciences Center, Recife, Pernambuco, Brazil.
Graduate Program in Human Communication Health at the Federal University of Pernambuco, Speech-Language Pathology and Audiology Department, Health Sciences Center, Recife, Pernambuco, Brazil.
J Voice. 2024 Sep;38(5):1255.e9-1255.e17. doi: 10.1016/j.jvoice.2022.03.005. Epub 2022 Apr 6.
Patients undergoing maxillectomies may present alterations in the stomatognathic functions involved in oral communication. Rehabilitative treatment should favor the rescue of these functions, through surgical flaps, obturator prostheses or both.
The present study aims to present the impact of the use of the palatal obturator on the oropharyngeal geometry and on the voice of patients undergoing maxillectomies, after adaptation to trans-surgical palatine obturators (TPO).
Twelve patients treated at a Cancer Hospital, submitted to maxillectomy and rehabilitated during surgery were evaluated. The oropharyngeal geometry was measured by acoustic pharyngometry and the vocal parameters were evaluated through auditory-perceptual and acoustic analyses. The comparison between the results with and without TPO was analyzed using the Wilcoxon test and the correlation between oropharyngeal measurements and acoustic parameters using Spearman's correlation coefficient, all with a significance level of 5%.
There was a decrease in the following oropharyngeal measurements with the use of TPO: length of the pharyngeal cavity and vocal tract, volume of the oral cavity, pharyngeal and vocal tract and area of the oropharyngeal junction. There was no difference in the length of the oral cavity and in the glottic area between situations with and without TPO. In the vocal evaluation, changes in intelligibility and resonance were observed in the situation without TPO and, in only one case, mild hypernasality was detected in the situation with TPO.
It is concluded that the use of TPO brought the oropharyngeal measurements closer to normal values and provided an improvement in speech intelligibility and vocal resonance in maxilectomized individuals.
接受上颌切除术的患者可能会出现与口腔交流相关的咀嚼功能改变。康复治疗应通过外科皮瓣、阻塞器义齿或两者结合来恢复这些功能。
本研究旨在介绍使用腭阻塞器对上颌切除术患者的口咽几何形状和语音的影响,这些患者在接受经外科腭阻塞器(TPO)适应治疗后。
对在癌症医院接受上颌切除术并在手术中进行康复治疗的 12 名患者进行评估。通过声学咽测图测量口咽几何形状,并通过听觉感知和声学分析评估语音参数。使用 Wilcoxon 检验分析 TPO 存在和不存在情况下的结果差异,并使用 Spearman 相关系数分析口咽测量值和声学参数之间的相关性,所有检验均设 5%的显著性水平。
使用 TPO 后,以下口咽测量值降低:咽腔和声道长度、口腔体积、咽腔和声道体积以及口咽交界处面积。TPO 存在和不存在情况下,口腔长度和声门区没有差异。在语音评估中,在无 TPO 的情况下,可懂度和共鸣发生变化,而在有 TPO 的情况下,仅在一个病例中检测到轻度鼻音过高。
TPO 的使用使口咽测量值更接近正常值,并在上颌切除术患者中提高了言语可懂度和嗓音共鸣。