Wong S H, Yuen A P, Cheung C, Wei W I, Lam L K
Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Am J Otolaryngol. 1997 Mar-Apr;18(2):94-8. doi: 10.1016/s0196-0709(97)90094-6.
Prosthetic voice restoration is an increasingly popular method of postlaryngectomy voice rehabilitation. Despite its success in non-tonal languages, the efficacy of tracheoesophageal speech in tonal languages was largely unknown. The aim of the present study was to evaluate the long-term results of voice rehabilitation using a Blom-Singer valve (BSV) in the tonal language of Cantonese.
The records of 159 patients who underwent total laryngectomy and primary tracheoesophageal puncture (TEP) between May 1985 and December 1994 were retrospectively reviewed. Tracheoesophageal speech was regarded as functional if effective communication could be made during face-to-face conversation and telephone conversation. Any TEP-related complications were noted. Perioperative factors that might contribute to nonfunctional speech were subjected to statistical analysis.
Six hospital mortalities were excluded from speech analysis. Of the remaining 153 patients, the median follow-up was 25 months, ranging from 3 to 113 months. Seventy-three patients had closure of tracheosophageal fistulae (TEF), and the main causes were ineffective voice production, dislodgment, and tracheostomal stenosis. Only 15 of them acquired functional speech before closure. The other 80 patients used a BSV as the chief modality of voice rehabilitation, with functional results achieved in 64 patients. None of the perioperative factors were found to be statistically significant in relation to nonfunctional speech.
Primary TEP is an established method of voice rehabilitation after total laryngectomy. In our series, 52% patients achieved functional tracheoesophageal speech using a BSV.
人工语音恢复是喉切除术后语音康复中一种越来越流行的方法。尽管它在非声调语言中取得了成功，但气管食管语音在声调语言中的疗效在很大程度上尚不清楚。本研究的目的是评估使用Blom-Singer瓣膜（BSV）进行粤语声调语言语音康复的长期效果。
回顾性分析了1985年5月至1994年12月期间接受全喉切除术和一期气管食管穿刺（TEP）的159例患者的记录。如果在面对面交谈和电话交谈中能够进行有效的沟通，则气管食管语音被视为功能正常。记录任何与TEP相关的并发症。对可能导致语音功能异常的围手术期因素进行统计分析。
6例医院死亡患者被排除在语音分析之外。在其余153例患者中，中位随访时间为25个月，范围为3至113个月。73例患者的气管食管瘘（TEF）闭合，主要原因是语音产生无效、移位和气管造口狭窄。其中只有15例在闭合前获得了功能性语音。其他80例患者使用BSV作为语音康复的主要方式，64例患者获得了功能性结果。未发现任何围手术期因素与语音功能异常有统计学意义。
一期TEP是全喉切除术后语音康复的一种成熟方法。在我们的系列研究中，52%的患者使用BSV实现了功能性气管食管语音。
