摘要
目的探讨喉全切除术后患者Ⅱ期行气管食管穿刺造瘘安装发音假体行发音重建后发音失败的原因,并找出有效的解决措施。方法34例喉癌、下咽癌患者,喉全切除术后6个月,安装发音假体7天后不能发气管食管音,观察其发音不成功的原因并作相应处理。结果34例发音失败者中,14例是因为环咽肌或咽下缩肌痉挛所致,切断咽缩肌或行咽缩肌神经丛切除术后,12例发音成功;11例因发音假体大小不合适,更换合适的发音假体后,10例发音良好;9例因造瘘口感染、瓣膜粘连闭合等,经对症处理后均能发出气管食管音。发音不成功的原因可概括为:①咽周围肌肉痉挛;②白色念珠菌沉积于瓣膜上或造瘘口感染;③发音假体大小不合适,太长或太短;④发音假体瓣膜变质、粘连闭合等。结论喉全切除术后安装发音假体失败的主要原因是并发症,可行选择性咽缩肌切断术或咽丛神经切断术、更换发音假体、抗炎治疗等,经过训练,可获得气管食管音。
Objective To study the reasons for the failed fitting of the voice prosthesis to the patients with trachea esophagus puncture fistula in II time so that proper solutions can be found. Methods 34 patients had total laryngectomy due to larynx or lower pharynx caners. Six month later they were fitted with the voice prosthesis, but seven days after fitting, they were still unable to produce the tracheoesophageal speech. Those patients were exam ined for the failures. Results All of the 34 cases were carefully studied from various aspects, such as unfit sizes of the prosthesis, surgical complications and otbers. A number of reasons were identified, Conclusion The main cause for the failure are the complications associated with surgeries. Solutions are recommended to avoid future failures that include performing suitable surgeries, changing unfit prosthesis and proper training. It is believed that after that the tracheoesophageal speech can be produced.
出处
《听力学及言语疾病杂志》
CAS
CSCD
2008年第5期395-397,共3页
Journal of Audiology and Speech Pathology
基金
淄博市科学技术局资助基金项目[淄卫字(2001)-225
项目编号:17号]
关键词
言语.无喉
喉切除术
发音重建
发音假体
Speech,laryngectomee
I.aryngectomy
Pronounce reconstruct
Voice prosthesis
