Kollbrunner J, Gadient M M, Aebischer S, Döbeli P, Zbären P
Universitätsklinik für HNO, Hals-, Kiefer- und Gesichtschirurgie Bern.
HNO. 1995 Apr;43(4):216-22.
The first 2 years' experiences with Provox prostheses at the ENT Clinic of the University of Berne are discussed. Thirty-three prostheses were inserted after primary tracheoesophageal puncture and 5 after secondary puncture. Voice success was measured with the scale of Robillard Shultz and Harrison, which encompasses not only assessment of voice quality but also frequency of use and a patient's independence in prosthesis care. After primary puncture the percentage of "functional" speakers increased progressively from 26% after 2 months to 56% after 1 year. After secondary puncture only 2 of 5 patients became functional speakers after 6 months. Because only a few of the previously laryngectomized patients who were informed about the possibility of a secondary puncture wished to receive a prosthesis, the reasons for their reservation were analyzed. Uneasiness about an additional operation and fear of complications were the most frequent motives. Further psychosocial aspects--including the unwillingness of some patients to use their fully functioning prosthesis--are discussed.
本文讨论了伯尔尼大学耳鼻喉科诊所使用Provox假体的头两年经验。33个假体在一期气管食管穿刺后植入，5个在二期穿刺后植入。语音成功程度采用Robillard Shultz和Harrison量表进行评估，该量表不仅涵盖语音质量评估，还包括使用频率以及患者在假体护理方面的独立性。一期穿刺后，“功能性”发声者的比例从2个月后的26%逐渐上升至1年后的56%。二期穿刺后，5名患者中只有2名在6个月后成为功能性发声者。由于之前被告知二期穿刺可能性的喉切除患者中只有少数希望接受假体，因此对他们保留态度的原因进行了分析。对额外手术的不安和对并发症的恐惧是最常见的动机。还讨论了进一步的社会心理因素，包括一些患者不愿意使用功能完全正常的假体的情况。
