Gervasio C F, Cavalot A L, Nazionale G, Magnano M, Ragona R, Bussi M, Staffieri A, Cortesina G
II Clinica ORL, Università di Torino.
Acta Otorhinolaryngol Ital. 1998 Apr;18(2):101-6.
Today there is increased need for an objective comparison between the various post-total laryngectomy phonatory rehabilitation techniques. This survey involves 20 patients who, after total laryngectomy, underwent rehabilitation using the esophageal voice (n = 10) or through the application of a secondary tracheal-esophageal prosthesis (n = 10). The multivariate analysis indicated that the only phonatory parameter which differed significantly between the two types of voice was the maximum phonation time (MPT) (p < 0.01). The MPT was markedly longer in patients with the tracheal-esophageal prosthesis. In patients with prosthesis, the Mann-Whitney test highlighted better figures for the following parameters: MPT (p = 0.0003), GP (maximum number of words that can be read in one breath) (p = 0.009), maximum intensity level (MIL) (p = 0.019), Shimmer (p = 0.008) and noise-to harmonics ratio (NHR) (p = 0.049). Furthermore, the Spearman test proved there is a relationship between MIL and GP, and between Pitch and Shimmer. Therefore, the tracheal-esophageal prosthesis seems to offer better phonatory energy and phonatory duration for every breath. However, these methods of objective inquiry need to be further developed so that comparison-among the different authors and among the different rehabilitation methods-can be made easier than it is now.
如今，对各种全喉切除术后发声重建技术进行客观比较的需求日益增加。本调查涉及20例患者，这些患者在全喉切除术后，采用食管发声（n = 10）或通过应用二期气管食管假体进行发声重建（n = 10）。多变量分析表明，两种发声类型之间唯一有显著差异的发声参数是最大发声时间（MPT）（p < 0.01）。使用气管食管假体的患者的MPT明显更长。在使用假体的患者中，曼-惠特尼检验显示以下参数有更好的数据：MPT（p = 0.0003）、一次呼吸能读出的最大单词数（GP）（p = 0.009）、最大强度水平（MIL）（p = 0.019）、微扰（p = 0.008）和噪声谐波比（NHR）（p = 0.049）。此外，斯皮尔曼检验证明MIL与GP之间、音高与微扰之间存在关系。因此，气管食管假体似乎能为每次呼吸提供更好的发声能量和发声持续时间。然而，这些客观探究方法需要进一步改进，以便不同作者之间以及不同重建方法之间的比较比现在更容易。
