Deschler D G, Doherty E T, Reed C G, Anthony J P, Singer M I
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco 94143.
Ann Otol Rhinol Laryngol. 1994 Dec;103(12):929-36. doi: 10.1177/000348949410301202.
Tracheoesophageal voice restoration after laryngectomy is possible with a variety of neopharyngeal reconstructions. We have used the tubed radial forearm free flap for neopharyngeal reconstruction since 1991. Six patients have undergone voice restoration with the Blom-Singer prosthesis and were available for quantitative and qualitative speech analysis. These patients were compared to five laryngectomy patients with standard pharyngeal closures and similar voice restorations. The free flap patients produced similar loudness levels compared to the standards with soft speech (52.06 dB and 47.19 dB, respectively) and loud speech (62.66 dB and 60.91 dB, respectively). The free flap patients demonstrated adequate intelligibility, with fundamental frequencies comparable to standards (124.82 Hz and 135.66 Hz, respectively), although with increased jitter (5.00% versus 1.96%). No differences were statistically significant, but evaluation by trained and naive listeners demonstrated significant differences in voice quality. This quantitative and qualitative and qualitative analysis of tracheoesophageal speech after radial forearm free flap reconstruction of the neopharynx demonstrates that acceptable voice can be achieved, but with limitations.
喉切除术后通过多种新咽重建方法可实现气管食管发音重建。自1991年以来，我们一直使用带蒂桡侧前臂游离皮瓣进行新咽重建。6例患者使用Blom-Singer假体进行了发音重建，并可进行语音的定量和定性分析。将这些患者与5例采用标准咽闭合术且发音重建情况相似的喉切除患者进行比较。游离皮瓣患者在轻声说话时（分别为52.06 dB和47.19 dB）和大声说话时（分别为62.66 dB和60.91 dB）与标准患者产生的响度水平相似。游离皮瓣患者表现出足够的可懂度，基频与标准患者相当（分别为124.82 Hz和135.66 Hz），尽管抖动增加（5.00%对1.96%）。没有差异具有统计学意义，但训练有素的听众和普通听众的评估表明语音质量存在显著差异。对桡侧前臂游离皮瓣重建新咽后的气管食管语音进行的这种定量和定性分析表明，可以实现可接受的语音，但存在局限性。
