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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 objectively evaluate the vocal function of patients with tracheo-esophageal (TE) sound after esophageal anastomosis shunt and vocal reconstruction after laryngectomy. Methods: Acoustic sound analysis and maximum vocalization time were compared between TE group, esophageal group and healthy group. The tracheal pressure was measured at 20 patients with TE sound. The electronic laryngoscope was used to observe the vibration of pharyngoesophageal mucosa and the morphology of “new glottis” in TE sound and esophageal sound. Results: There was no significant difference in acoustic parameters between TE and esophageal sound, but compared with healthy group, except fundamental frequency and amplitude, fundamental frequency perturbation, amplitude perturbation, harmonic ratio and normalized noise energy Other parameters were statistically significant. The endotracheal pressure of patients with TE sound was (2.86 ± 0.96) kPa. Most of the pharyngeal esophageal mucosa of the two groups did not vibrate at the time of vocalization, and the shape of the new glottis was mostly ring-shaped. Conclusion: The phonological characteristics of TE sound group are similar to those of esophageal sound group, and they are significantly different from those of healthy group. However, the tone of TE sound is closer to that of healthy group. The vocal reconstruction after the patient sound squeamish.