Migliorelli Andrea, Natale Erennio, Manuelli Marianna, Ciorba Andrea, Bianchini Chiara, Pelucchi Stefano, Stomeo Francesco
ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, via Aldo Moro 8, 44100 Ferrara, Italy.
J Clin Med. 2024 Jul 27;13(15):4392. doi: 10.3390/jcm13154392.
: Tracheoesophageal voice is the most commonly used voice rehabilitation technique after a total laryngectomy. The placement of the tracheoesophageal prosthesis can be performed at the same time as the total laryngectomy (primary placement) or in a second procedure after surgery (secondary placement). The purpose of this study is to analyze the substitution voice in patients with a tracheoesophageal prosthesis, considering the influence of radiotherapy and timing of prosthesis placement (primary or secondary) on voice quality. A retrospective analysis was conducted of all patients who received a tracheoesophageal phonatory prosthesis after a total laryngectomy was performed. We assessed whether patients received radiotherapy and whether they had a primary or secondary tracheoesophageal prosthesis. For the voice analysis, maximum phonation time (MPT), INFVo, SECEL, AVQI, CPPS, harmonic to noise ratio (HNR), unvoiced fraction (UVF), and number of voice breaks (NVB) were evaluated. A total of 15 patients (14 males and 1 female) with a mean age of 71.8 years (SD ± 7.5) were enrolled. Eight had a primary prosthesis placement and five did not receive radiotherapy. INFVo parameters I and Vo were higher in patients with a primary placement of the phonatory prosthesis ( = 0.046 and = 0.047). Patients who received the prosthesis secondarily had a higher mean CPPS and lower mean AVQI. A secondary placement of the prostheses seems to result in a minimal advantage in voice quality compared to a primary placement. Radiation therapy, on the other hand, has no effect on voice quality, according to these preliminary data.
气管食管发音是全喉切除术后最常用的语音康复技术。气管食管假体的放置可与全喉切除术同时进行（一期放置），也可在手术后的二次手术中进行（二期放置）。本研究的目的是分析气管食管假体患者的替代语音，考虑放疗以及假体放置时间（一期或二期）对语音质量的影响。对所有全喉切除术后接受气管食管发音假体的患者进行了回顾性分析。我们评估了患者是否接受放疗以及他们使用的是一期还是二期气管食管假体。对于语音分析，评估了最长发声时间（MPT）、初始噪声基频（INFVo）、声门关闭瞬间至第一谐波频率（SECEL）、平均嗓音质量指数（AVQI）、辅音发音清晰度百分比（CPPS）、谐波噪声比（HNR）、清音比例（UVF）和嗓音中断次数（NVB）。共纳入15例患者（14例男性和1例女性），平均年龄71.8岁（标准差±7.5）。8例患者进行了一期假体植入，5例未接受放疗。一期植入发音假体的患者的INFVo参数I和Vo较高（P = 0.046和P = 0.047）。二期植入假体的患者平均CPPS较高，平均AVQI较低。与一期植入相比，二期植入假体在语音质量方面似乎优势不大。另一方面，根据这些初步数据，放疗对语音质量没有影响。
