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目的:探讨喉癌功能性外科手术喉环上切除术(SCPL)后,新喉的嗓音学特征及喉发声共振体的振动特性。方法:应用Dr.Speech(DSS)技术及频谱分析法,对21例患者行SCPL4种不同术式,即A:环状软骨舌骨会厌固定术(SCPLCHEP),B:环状软骨舌骨固定术(SCPLCHP),C:气管环状软骨舌骨会厌固定术(SCPLTCHEP),D:气管环状软骨舌骨固定术(SCPLTCHP),并对术后嗓音学参数进行分析比较。结果:4种不同术式术后新声门区的振动模式大致相同,表现为黏膜波动增强,新声门区的振动模式随患者术后时间的推移而逐渐增强,且渐趋于稳定;患者术前、术后的基频、基频微扰、振幅微扰、标准化噪声能量及谐噪比等声学参数对比正常值,差异均有统计学意义。结论:SCPL中切除双侧声带和室带,保留两侧或一侧环杓单元即可重建新喉的发声功能,同时能保留喉的吞咽、呼吸功能和维持声门下压的生理功能;新喉的嗓音声学特征非常明确。
Objective: To investigate the vocal characteristics of the new larynx and the vibrational characteristics of the laryngeal phonon resonators after functional surgical laryngectomy (SCPL). Methods: Four kinds of SCPL were operated on 21 patients under the guidance of Dr.Speech (DSS) technique and spectral analysis method, namely A: Cyclic chondral epiphyseal fixation (SCPLCHEP), B: Cyclic chondral hyoid fixation (SCPLCHP) C: SCPLTCHEP, D: SCPLTCHP, and postoperative vocal parameters were analyzed and compared. Results: The vibration modes of the new glottis area after operation were similar, showing the increase of mucosal vibration. The vibration mode of the new glottis area gradually increased with the passage of time and gradually stabilized. The patients Preoperative and postoperative basic frequency, fundamental frequency perturbation, amplitude perturbation, normalized noise energy and harmonic ratio and other acoustic parameters compared with normal, the differences were statistically significant. CONCLUSIONS: The excision of bilateral vocal cords and ventricular bands in the SCPL can preserve the vocal function of the larynx and maintain the physiological function of the glottis, while preserving the vocal function of the new larynx on both sides or on one side of the ladle unit. Voice acoustic features are very clear.