Geraghty J A, Wenig B L, Smith B E, Portugal L G
Department of Otolaryngology-Head and Neck Surgery, University of Illinois College of Medicine at Chicago, USA.
Ann Otol Rhinol Laryngol. 1996 Jul;105(7):501-3. doi: 10.1177/000348949610500701.
Since its introduction by Blom and Singer in 1980, tracheoesophageal puncture with a voice prosthesis has become the most frequently recommended choice for speech rehabilitation of total laryngectomies. Many studies have reviewed the initial speech acquisition success rates following tracheoesophageal puncture; however, long-term follow-up in these initial successes has been lacking. In addition, factors predictive of long-term success with tracheoesophageal speech have not been defined. Over a 10-year period, we retrospectively reviewed all total laryngectomy patients, including those who have undergone primary or secondary tracheoesophageal puncture, at the University of Illinois Hospital and Clinics and the Westside Veterans Administration Hospitals. Survival in the total laryngectomy cohort of 202 patients ranged from 35% to 50%. Forty of these patients underwent tracheoesophageal puncture, in whom survival was 75%. Short-term success with tracheoesophageal speech was approximately 70% for our patients, while long-term success was achieved in 66%. Despite low socioeconomic status and relatively high alcoholism rates, successful maintenance of tracheoesophageal speech was achieved in the majority of cases. Tracheoesophageal speech should therefore be considered as a primary method of vocal rehabilitation in all patients undergoing total laryngectomy.
自1980年布洛姆和辛格引入以来，带语音假体的气管食管穿刺术已成为全喉切除术后言语康复最常推荐的选择。许多研究回顾了气管食管穿刺术后的初始言语获得成功率；然而，这些初始成功案例缺乏长期随访。此外，尚未明确预测气管食管言语长期成功的因素。在10年期间，我们回顾性研究了伊利诺伊大学医院及诊所和西区退伍军人管理局医院的所有全喉切除术患者，包括那些接受过初次或二次气管食管穿刺的患者。202例全喉切除队列患者的生存率在35%至50%之间。其中40例患者接受了气管食管穿刺，其生存率为75%。我们的患者气管食管言语短期成功率约为70%，长期成功率为66%。尽管社会经济地位较低且酗酒率相对较高，但大多数病例仍成功维持了气管食管言语。因此，气管食管言语应被视为所有接受全喉切除术患者言语康复的主要方法。
