[The observation on the mechanism of speech forming by slit-like trachea-esophagus puncture after total laryngectomy].

ABSTRACT

OBJECTIVE: To observe the mechanism of the rehabilitated speech using slit-like fistula between trachea and esophagus after total laryngectomy. METHOD: Forty patients after total laryngectomy all come from the fourth central hospital of Tianjin. They all reconstructed voice using slit-like fistula between trachea and esophagus primary or secondary stage. We use teleradiography and laryngotroboscope to observe its mechanism of store gas stage, deliver gas stage and phonation stage. RESULT: While inspiratory, the pulmonary enlarged, and the upper esophagus was closed and circulus invension. After this, the infra-pharyngeal cavity expanded, looks like a downward triangular taper. The upper end of the esophagus opened suddenly. Phonation begin, the superior esophagus was full of air as a ball. The air escape through the segment of trachea-esophagus. The meatus of esophagus opened in coronal position and turn over like lip. It is vibrated together with nearby mucus, mucosa to form voice. After that, thorax shrink, the meatus of esophagus turn in again, the voice behavior is over. CONCLUSION: The power organ of trachea-esophagus voice is lung. It is crucial for the trachea-esophagus fistula unobstructed and smooth to forming voice. When phonation, the mucosa, mucus of infra-pharyngeal and esophageal meatus take part in vibration.