喉全切除术后应用电子喉发音的X线研究

Xray Study of Phonation with Electrolarynx after Total Laryng ectomy

目的：讨论喉全切除术后患者应用电子喉发音的Ｘ线表现，并探讨用电子喉发音的“假声门”。材料与方法：在Ｘ线吞钡透视下动态观察９例无喉者应用电子喉发音时的舌、咽、食管等部位的表现，并摄片分析。结果：发电子喉音时：（１）咽食管段水平椎体前软组织隆起、增厚明显；（２）下咽腔明显增宽；（３）舌根部与咽后壁粘膜之间形成一狭窄区；（４）该狭窄区与电子喉最佳放置部位基本在同一水平，在Ｃ２～Ｃ４之间，以Ｃ３为主。结论：在舌根部与咽后壁粘膜之间形成的狭窄区，可能是发电子喉音的“假声门”。

Objective: To discuss Xray manifestation and “pseudoglottis” of patient's phonation with electrolarynx after total laryngectomy.Materials and Methods:The manifestations in tongue, pharynx and esophagus of 9 laryngectomees who used electrolarynx to phonate were observed by ingestion of barium, in this manner sets of moving pictures were analyzed.Results:The Xray analysis during phonation with electrolarynx suggested that: (1) Prevertebral soft tissue was significantly bulge at the level of pharyngoesophageal segment; (2) Width of the hypopharynx was significantly wide; (3) A narrow area was formed between glossal root and mucous membrane of the posterior pharyngeal wall; (4) The narrow area was at the level of the most appropriate position for electrolarynx, generally between the 2nd cervical vertebra and the 4th cervical vertebra, mostly at the 3rd cervical vertebra.Conclusion: The narrow area was probably a“pseudoglottis” during phonation with electrolarynx.