RESUMO
Voice rehabilitation in the laryngectomy patient has been a major goal of reconstructive laryngeal surgery. 36 patients underwent laryngectomy with the creation of a phonatory neoglottis as outlined by Staffieri. In 13 patients good voice rehabilitation was achieved. In 23 patients who failed to develop voice production, altered swallowing function was the major problem.
Assuntos
Glote/cirurgia , Laringe Artificial/métodos , Complicações Pós-Operatórias/etiologia , Adulto , Idoso , Carcinoma de Células Escamosas/cirurgia , Deglutição , Humanos , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Faringostomia , Fonação , TraqueostomiaAssuntos
Neoplasias Laríngeas/cirurgia , Laringectomia/reabilitação , Voz Alaríngea , Adulto , Neoplasias Esofágicas/reabilitação , Neoplasias Esofágicas/cirurgia , Humanos , Neoplasias Laríngeas/reabilitação , Laringectomia/métodos , Laringe Artificial/métodos , Masculino , Neoplasias Faríngeas/reabilitação , Neoplasias Faríngeas/cirurgia , Voz Alaríngea/métodos , Voz EsofágicaRESUMO
The achievement of intonational contrasts by 4 normal and 16 laryngectomized speakers was assessed in this project. The laryngectomized subjects represented four clinical subgroups of alaryngeal speech: esophageal, tracheoesophageal, Western Electric #5 electrolarynx, and Servox electrolarynx. High-quality tape recordings of each subject's productions of two pairs of sentences (Bev loves Bob) spoken in statement and question from were presented to 40 listeners for evaluation using a two-interval-alternative-forced-choice procedure. Intonational contrasts were achieved in a highly effective manner by the normal, esophageal, and tracheoesophageal speakers. In contrast, users of electronic artificial larynges were generally unable to achieve these intonational distinctions except for one user of the Western Electric #5 electrolarynx.
Assuntos
Acústica da Fala , Voz Alaríngea , Fala , Adulto , Idoso , Humanos , Laringe Artificial/métodos , Masculino , Pessoa de Meia-Idade , Semântica , Inteligibilidade da Fala , Percepção da Fala , Voz Alaríngea/métodos , Voz EsofágicaRESUMO
In experimental animals a one stage surgical procedure has been developed which at laryngectomy allows for the creation of a wide and patent tracheopharyngeal fistula. An endotracheal artificial larynx has been developed which has been found effective in prevention of aspiration in experimental animals. Bench studies indicate that an adequate voice probably can be obtained with this device.
Assuntos
Laringe Artificial , Animais , Transtornos de Deglutição/prevenção & controle , Cães , Laringectomia , Laringe Artificial/instrumentação , Laringe Artificial/métodos , Modelos Biológicos , Qualidade da VozRESUMO
Follow up of 45 patients who had undergone a surgical voice rehabilitation by Asai's or Staffieri's method showed clearly that the main problem of such operations is not the restoration of a good voice but the guarantee of a normal swallow. The low position of the tracheo-pharyngeal fistula in Staffieri's operation is particularly disadvantageous and often requires surgical closure of the neoglottis. A strict pre-operative assessment is indicated before all operative methods for voice rehabilitation. Oesophageal speech remains the best voice after laryngectomy and operative reconstruction is relegated to second place.