van As C J, Hilgers F J, Koopmans-van Beinum F J, Ackerstaff A H
Department of Otolaryngology, Head and Neck Surgery, The Netherlands Cancer Institute (Antoni van Leeuwenhoek Hospital), University of Amsterdam.
Acta Otolaryngol. 1998 Sep;118(5):732-8. doi: 10.1080/00016489850183278.
In this study, speech of 21 laryngectomized patients is investigated under 2 different stoma occlusion conditions, i.e. direct digital occlusion of the stoma (by thumb or finger), and digital occlusion (by finger) via a special heat and moisture exchanger with speech valve (Provox Stomafilter). For both conditions, acoustical analyses of voice quality (various pitch, amplitude, tremor and harmonicity measures) were performed on a sustained /a/, the mean maximum phonation time was calculated, and a phonetogram was made. Acoustical analysis was possible in 13 of the 21 voices (for the other voices, the pitch was too low or the voice was too aperiodic), but no statistical significant differences were found for any of the acoustical parameters studied. However, the maximum phonation time was significantly longer, and the dynamic range significantly larger, under the Stomafilter occlusion condition. The maximum phonation time showed a relevant improvement in 57% of the patients, while the dynamic range showed a relevant improvement in 35% of the patients. In total, 75% of the patients experience an improvement in one or both of these speech characteristics when using the Stomafilter occlusion. It can be concluded that optimal stoma occlusion by means of a specialized device has a positive influence on two relevant parameters of prosthetic voice production: maximum phonation time and dynamic loudness range.
在本研究中，对21名喉切除患者在两种不同的造口闭塞条件下的语音进行了研究，即直接用手指闭塞造口（用拇指或手指），以及通过带有语音阀的特殊热湿交换器（Provox Stomafilter）用手指闭塞。对于这两种情况，均对持续发/a/音进行了嗓音质量的声学分析（各种音高、振幅、震颤和谐波性测量），计算了平均最大发声时间，并制作了语音图。21个声音中有13个可以进行声学分析（对于其他声音，音高过低或声音过于非周期性），但在所研究的任何声学参数中均未发现统计学上的显著差异。然而，在使用Stomafilter闭塞条件下，最大发声时间明显更长，动态范围明显更大。最大发声时间在57%的患者中显示出相关改善，而动态范围在35%的患者中显示出相关改善。总体而言，75%的患者在使用Stomafilter闭塞时，这两种语音特征中的一种或两种都有改善。可以得出结论，通过专门设备进行最佳造口闭塞对人工嗓音产生的两个相关参数有积极影响：最大发声时间和动态响度范围。
