喉全切除发声重建术后发声功能评估  

Phonation assessment of voice restoration after laryngectomy

作　　者：肖淑芬[1] 李晓明[1] 尚耀东[1] 李琦[1] 贺银芳[1] 

机构地区：[1]白求恩国际和平医院耳鼻咽喉-头颈外科全军耳鼻咽喉病中心,石家庄050082

出　　处：《临床耳鼻咽喉科杂志》2004年第9期530-532,535,共4页Journal of Clinical Otorhinolaryngology

摘　　要：目的 :对喉全切除气管断端膜样部食管吻合分流发声重建术后气管食管 (TE)音患者的发声功能进行客观评估。方法 :对TE音组、食管音组及健康组进行发声声学分析及最大发声时间比较。测定了 2 0例TE音患者舒适发声时的气管内压。在电子喉镜下观察TE音和食管音患者发声时咽食管段黏膜的振动情况及“新声门”的形态。结果 :TE音与食管音相比各发声声学参数差异均无统计学意义 ,而与健康组相比 ,除基频、振幅外 ,基频微扰、振幅微扰、谐噪比和标准化噪声能量等参数均有统计学意义。TE音患者舒适发声时的气管内压为(2 .86± 0 .6 9)kPa。两组无喉音发声时的咽食管段黏膜大多振动规律 ,新声门形状多为环状。结论 :TE音组的发声声学特征同食管音组相近 ,与健康组相比均有显著差异 ,但TE音的音调更接近健康组。本发声重建术后患者发声省力。Objective:To take an objective phonation assessment for the patients who have taken the tracheo-esophageal (TE) shunt procedure after total laryngectomy.Method:Twenty-four patients after TE shunt procedure were selected as TE group. Esophageal speakers after total laryngectomy and normal subjects were considered as controls. All the subjects of three groups took part in the voice acoustic assessment and MPT measurement. Twenty TE speakers took part in intra-tracheal pressure measurement. TE speakers and esophageal speakers participated in the electronic laryngoscope examination.Result:There were no significant differences between TE group and esophageal group in every acoustic parameters,but there were very remarkable differences between TE group and normal subjects in jitter, shimmer, harmonics to noise ratio and normalized noise energy. The pressure of TE speakers for comfortable /a/ is ( 2.86 ± 0.69 )kPa.The pharyno-esophageal segment vibrated regularly in most alaryngeal speakers and shapes of neo-glottis of most alaryngeal speakers were circular.Conclusion:Acoustic parameters of TE speakers were similar to those of esophageal speakers, but the tone of TE speakers was more similar to the normal controls. Speaking of the patients after the TE shunt procedure is laborsaving.

关 键 词：喉切除术 发声重建术 言语声学 

分 类 号：R767.92[医药卫生—耳鼻咽喉科]