无喉患者食管发音的影像学表现及临床意义  

Imaging Manifestation and Clinical Signification of Esophageal Speech in Laryngectomees

作　　者：郭艺[1] 李敏健[1] 郭镇平[2] 余林[1] 

机构地区：[1]广州医科大学附属第二医院放射科,广东广州510260 [2]广州医科大学附属第二医院耳鼻喉科,广东广州510260

出　　处：《中国医学影像学杂志》2014年第1期16-18,共3页Chinese Journal of Medical Imaging

摘　　要：目的探讨无喉患者食管发音的X线造影表现及临床意义。资料与方法采用食管吞钡造影检查对比分析5例无喉食管发音成功者(食管发音组)与5例健康志愿者(对照组)在不发音与发"依"音时的食管及下咽的影像学特征。结果不发音时,食管发音组下咽-食管上段呈轻度充气状态,食管入口欠平顺、光滑;对照组下咽-食管上段基本无气体积聚,食管入口平顺、光滑。发"依"音时,食管发音组下咽-食管上段呈明显的储气袋,食管入口后壁明显前凸呈指样压迹;对照组下咽-食管上段仅有少量气体充盈,食管入口平顺、光滑。结论无喉食管发音成功者的咽-食管上段储气及食管入口的形态改变明显,这种改变是无喉患者成功应用食管发音的形态学基础,具有重要的临床意义。Purpose To evaluate the imaging manifestation and clinical signification of esophageal speech in laryngectomees. Materials and Methods Esophageal barium swallow radioscopy was performed in five laryngectornees with successful esophageal phonation （observation group） and five normal volunteers （control group） when they were swallowing and pronouncing ＂yi＂, imaging characteristics were compared and analyzed between the observation group and the control group. Results Mild-inflation of the hypopharynx to upper esophagus segment could be observed during barium swallowing in the observation group, and the esophageal entrance was less smooth; while the control group demonstrated almost no inflation and the esophageal entrance was smooth during the swallowing. During the pronunciation of＂yi＂, an obvious gas storage bag was Formed in the hypopharynx to upper esophagus segment in the esophageal phonation group, and posterior wall of the esophageal entrance showed significant lordosis which formed a finger-shaped notch; while in the control group, only little gas filling can be observed and the esophageal entrance was smooth. Conclusion The imaging presentations of inflation of the hypopharynx to upper esophagus segment and the esophageal entrance in laryngectornees when swallowing and pronouncing ＂yi＂ are evidently different from the normal persons, these changes not only provide the morphological basis for esophageal phonation, but also correlate significantly with the duration and loudness of phonation, thus are of important clinical significance.

关 键 词：喉切除术 言语 无喉 言语 食管 发声 放射摄影术 钡 

分 类 号：R445.4[医药卫生—影像医学与核医学] R322.43[医药卫生—诊断学]