Uticaj obima hirurške resekcije kod totalne laringektomije na uspostavljanje ezofagusnog glasa i govora
Uticaj obima hirurške resekcije kod totalne laringektomije na uspostavljanje ezofagusnog glasa i govora
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Uticaj obima hirurške resekcije kod Totalne laringektomije na uspostavljanje ezofagusnog glasa i govora
DOI：
10.2298/aci0401037s
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
B. L. Janosevic
中科院分区：
文献类型：
--
作者：
P. Stankovic;Vojko Djukic;Milan Vukasinovic;B. L. Janosevic
全喉切除术功能结果的研究离不开食道语音和言语的发音。为了使laringectomy患者语音康复成功，必须充分认识手术本身的病理后遗症、肿瘤危险因素的长期不良影响以及术后的解剖生理变化。全喉切除术的解剖结果取决于手术干预的类型和可能的放射治疗。手术的程度主要由肿瘤指征决定，对食道语音和言语的发音有重要影响。如果可能的话，由于肿瘤原因，舌骨尤其应该保持完整。在喉切除术、颈部清扫术（尤其是根治性清扫术）及随后的放疗过程中，对下咽及舌底进行广泛的手术干预，均显著降低了食管语音产生的可能性。全喉切除术消除了声音和振动的创造者，这些声音和振动在声学上被认为是食道声音，在咽-食道交界处进行。因此，新创建的振动变窄的质量尤为重要。
: The study of functional results of total laryngectomy cannot be separated from articulation of esophageal voice and speech. To achieve success of phoniatric rehabilitation in laringectomized patients, it is necessary to be well aware of pathological sequelae of the very operation, long-term adverse effect of oncological risk factors as well as postoperative anatomo-physiological changes. Anatomic results of total laryngectomy depend on the type of surgical intervention and probable radiotherapy. The extent of surgical procedure, primary dictated by oncological indications, has the essential effect to articulation of esophageal voice and speech. If possible for oncological reasons, hyoid bone should be particularly left intact. Extensive surgical interventions of hypopharynx and the base of the tongue during laryngectomy, neck dissection--especially the radical one, and subsequent radiotherapy, all of them significantly reduce the possibility to produce esophageal voice and speech. Total laryngectomy eliminates the creator of voice and vibrations, which are acoustically perceived as esophageal voice, proceeding at the level of pharyngoesophageal junction. For this reason, the quality of newly created vibrating narrowing is especially important.