Culton G L, Gerwin J M
Department of Communicative Disorders, University of Alabama, Tuscaloosa, USA.
Otolaryngol Head Neck Surg. 1998 Apr;118(4):458-63. doi: 10.1177/019459989811800405.
This study determined the perceptions of experienced speech-language pathologists regarding current practices in the speech rehabilitation of laryngectomy patients since the introduction of the tracheoesophageal puncture-voice prosthesis technique in 1980. The sample population consisted of 151 experienced speech-language pathologists, or 43% of those who were sent questionnaires. The speech-language pathologists ranked tracheoesophageal puncture-voice prosthesis as their most preferred speech rehabilitation method and the electrolarynx as their least preferred, even though the electrolarynx continues to be the most frequently used method. Variable use of the tracheoesophageal puncture procedure by otolaryngologists was reported, with only a small portion perceived as using it routinely. About 65% of the speech-language pathologists reported that more than half of the laryngectomy patients were being given choices among speech rehabilitation methods. Nearly 50% of the speech-language pathologists reported that fewer than six speech therapy sessions were necessary with tracheoesophageal puncture patients, whereas more than 20% reported the need for 10 sessions or more. Use of manual closure of the tracheostoma by tracheoesophageal puncture patients far outweighed their use of automatic speaking valves. Most speech-language pathologists reported that they were involved in teams with otolaryngologists to determine patient suitability for tracheoesophageal puncture and to troubleshoot problems. Eighteen different categories of medical and speech production problems were reported.
本研究确定了自1980年引入气管食管穿刺-发音假体技术以来，经验丰富的言语病理学家对喉切除患者言语康复当前做法的看法。样本群体由151名经验丰富的言语病理学家组成，占收到问卷者的43%。言语病理学家将气管食管穿刺-发音假体列为他们最青睐的言语康复方法，而将电子喉列为最不青睐的方法，尽管电子喉仍是最常用的方法。据报告，耳鼻喉科医生对气管食管穿刺手术的使用情况各不相同，只有一小部分被认为是常规使用。约65%的言语病理学家报告说，超过一半的喉切除患者在言语康复方法上有选择。近50%的言语病理学家报告说，气管食管穿刺患者所需的言语治疗疗程少于6次，而超过20%的人报告需要10次或更多疗程。气管食管穿刺患者手动封闭气管造口的情况远远多于使用自动发声阀的情况。大多数言语病理学家报告说，他们与耳鼻喉科医生组成团队，以确定患者是否适合气管食管穿刺并解决问题。报告了18种不同类型的医疗和言语产生问题。
