Leder S B, Sasaki C T
Yale University School of Medicine, Section of Otolaryngology, New Haven, CT 06504, USA.
Laryngoscope. 1995 Aug;105(8 Pt 1):827-32. doi: 10.1288/00005537-199508000-00011.
The Blom-Singer method of tracheoesophageal (TE) speech restoration is a proven alternative to esophageal and electrolaryngeal speech in patients with total laryngectomy. This retrospective study was undertaken to determine the incidence and timing of TE prosthesis resizing, amount of change in prosthesis length, etiologies associated with resizing, and importance of long-term professional follow-up for maintenance of successful TE speech production. Participants were 26 individuals with total laryngectomy and secondary TE puncture. Results indicated that all 18 participants available for long-term follow-up required TE prosthesis resizing, and multiple resizings were required in 87% of the routinely followed participants. In 14 participants the prostheses were resized shorter (sample mean [mean] = -0.7 cm); in 3, longer (mean = +0.5 cm); and in 1, from a duckbill to a low-pressure prosthesis of the same size. The mean number of days from initial measurement and fitting to first prosthesis resizing was 26. The importance of collaboration between the speech-language pathologist and otolaryngologist and need for long-term follow-up for successful maintenance of TE speech are stressed. Cost containment of rehabilitation services using the indwelling TE prosthesis is demonstrated.
Blom-Singer气管食管（TE）语音恢复方法是全喉切除患者食管语音和电子喉语音的一种经证实的替代方法。本回顾性研究旨在确定TE假体尺寸调整的发生率和时间、假体长度的变化量、与尺寸调整相关的病因，以及长期专业随访对维持成功的TE语音产生的重要性。参与者为26例全喉切除并继发TE穿刺的个体。结果表明，所有18例可进行长期随访的参与者都需要调整TE假体尺寸，87%的常规随访参与者需要多次调整。14例参与者的假体尺寸调短（样本均值[均值]= -0.7 cm）；3例调长（均值= +0.5 cm）；1例从鸭嘴形假体更换为相同尺寸的低压假体。从初次测量和安装到首次调整假体尺寸的平均天数为26天。强调了言语病理学家和耳鼻喉科医生之间合作的重要性以及长期随访对成功维持TE语音的必要性。展示了使用留置TE假体的康复服务的成本控制情况。
