权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Pathophysiological study of neoglottis

新声门的病理生理学研究

基本信息

批准号：
11835044
负责人：
MAKIYAMA Kiyoshi
金额：
$ 2.18万
依托单位：
Nihon University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1999
资助国家：
日本
起止时间：
1999 至 2000
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11835044/
关键词：
Laryngectomized patients Voice reconstruction Neoglottis Phonatory function High-speed digital imaging T-E shunt Esophageal speech Expiratory lung pressure

项目摘要

This study was conducted to investigate the neoglottis and phonatory function after elephant type voice reconstruction using a free jejunal autograft in comparison with the patients of esophageal speech or T-E shunt. The neoglottic vibration was investigated using high-speed digital image recording System. Expiratory lung pressure during phonation was determined simultaneously with the fundamental frequency, sound pressure level, and mean flow rate (MFR), using the phonatory function analyzer NAGASHIMA PS77E.The first group underwent total laryngectomy. The hypopharyngeal mucosa above the esophageal entrance plays the role of the neoglottis of the esophageal speech. The mucosal surface of the neoglottis protrudes like a valve and vibrates. In the patient with a T-E shunt, the neoglottis is closed and vibrates during phonation.The second group underwent laryngopharyngoesophagectomy with a free jejunal graft : elephant type shunt. Mucosal vibration is seen in the lumen of the jejunum. In contrast to esophageal speech, the neoglottis remains open during phonation. We consider that when the expiratory air passes through the shunt to the jejunal lumen, the local mucosa is sucked by the Bernoulli effect to serve as a sound source.In the first group, both expiratory lung pressure and MFR were in low or normal level. In the elephant type voice reconstruction group, the pressure and MFR were in high level. The airway resistance, which is the expiratory lung pressure per MFR quotient, was high in the elephant group. Because the lumen of the voice reconstruction site is narrow and possesses mucosal folds, airway resistance should be high during expiration. In other words, a high expiratory lung pressure is required due to an airway stenosis between the trachea and neoglottis in the elephant group.Based on the present results, we wish to improve surgical techniques and training methods for better voice restoration.

本研究旨在调查使用游离自体空肠移植物重建大象型声音后的新声门和发声功能，并与接受食管言语或 T-E 分流术的患者进行比较。使用高速数字图像记录系统研究新声门振动。使用发声功能分析仪 NAGASHIMA PS77E 同时测定发声过程中的呼气肺压以及基频、声压级和平均流速 (MFR)。第一组接受全喉切除术。食管入口上方的下咽粘膜起着食管言语的新声门的作用。新声门的粘膜表面像瓣膜一样突出并振动。在接受 T-E 分流术的患者中，新声门闭合并在发声期间振动。第二组接受了带有游离空肠移植物的喉咽食管切除术：大象型分流术。空肠腔内可见粘膜振动。与食管言语相反，新声门在发声期间保持开放。我们认为，当呼出气体通过分流管进入空肠腔时，局部粘膜受伯努利效应的作用而被吸入，成为声源。第一组的呼气肺压和MFR均处于低或正常水平。在大象型声音重建组中，压力和MFR处于高水平。大象组的气道阻力（即每 MFR 商的呼气肺压力）较高。由于声音重建部位的管腔狭窄且有粘膜皱襞，因此呼气时气道阻力应较高。换句话说，由于象群气管和新声门之间的气道狭窄，需要较高的呼气肺压力。根据目前的结果，我们希望改进手术技术和训练方法，以更好地恢复声音。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Seiji Niimi, Mamiko Miyaji: "Vocal fold vibration and voice quality."Folia Phoniatr Logop. 52. 32-38 (2000)

Seiji Niimi、Mamiko Miyaji：“声带振动和声音质量。”Folia Phoniatr Logop。

DOI：
发表时间：
期刊：
影响因子：
0
作者：
通讯作者：

牧山清: "エレファント型音声再建術施行例の新声門の観察"音声言語医学. 41卷・1号. 25-26 (2000)

Kiyoshi Makiyama：“大象型声音重建病例中新声门的观察”《言语与语言医学》第 41 卷，第 1. 25-26 期（2000 年）。

DOI：
发表时间：
期刊：
影响因子：
0
作者：
通讯作者：

Kenji Sasaki, Motohiro Nozaki, Hiroko Ide, Akinori Kida, Shoji Takeoda, Naoko Kashima, Kazuaki Ogawa: "Voice restoration after laryngopharyngoeso -phagectomy with a free jejunal graft : Elephant-type shunt."J Jpn Bronchoesophagol Soc. 50-2. 242-247 (1999)

Kenji Sasaki、Motohiro Nozaki、Hiroko Ide、Akinori Kida、Shoji Takeoda、Naoko Kashima、Kazuaki Okawa：“用游离空肠移植物进行咽喉吞噬切除术后的声音恢复：大象型分流术。”J Jpn Bronchoesophagol Soc。