喉环上切除术后的嗓音研究

Vocal sound study in supracricoid partial laryngectomy

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：Vocal sound was studied in 21 patients underwent supracricoid partial laryngectomy using Dr. Speech. Method： Vocal sound tests and frequency spectrum analysis were used in 4 different approaches （CHEP, CHP, TCHEP, TCHP） both before and after the operation. Result： Vibration pattern of new glottides formed after the four different operation approaches was approximately the same demonstrating an augmentation of mucous membrane flactuation. This vibration pattern were increasing and stabilizing gradually with time. Conclusion：Retaining on both sides and one side in supracricoid partial laryngectomy facilitates restoration of vocal fonction.