Voice rehabilitation in patients who underwent laryngectomy

本研究的目的是建立一套喉切除术后重度发音困难患者新舌炎的生理分析方法/装置，并根据数据分析结果改进发音康复。利用Kay的高速数字摄影系统，将图像记录系统、电子喉镜和高质量打印机集成到单元中，构建了用于声源观察的高速数字成像系统。在对喉切除术后食道发声患者的检查中，从吞气到新声道炎的形成，新声门粘膜振动的形成，以及发声的终止，都可以进行详细的观察和分析。黏膜振动周期不规则，不同周期其大小不同。可能的原因是下咽粘膜气流过少，咽下缩肌调节不一致。对于…在这些情况下，还有恢复计划，如增加保留在食道内的气流，调节胸腔内压力的能力，调节咽下缩肌的调节能力。声源存在于正常声带、正常声带后部至颧骨区或正常假声带。我们推测新声门的位置是由术后喉形态和发声方法共同决定的。声带振动正常的患者音质最高。因此，为了改善发声功能，在与正常声带相对的皮瓣区产生空气阻力的方法。由于正常声带或假声带过度内收会导致声音嘶哑，因此有效利用呼出的空气的发音指导也是必要的。较少

The purposes of this study were to establish a method/apparatus for the physiological analysis of neogllotis in patients with severe dysphonia after laryngectomy, and to improve voice rehabilitation based on the results of data analysis.Using a Kay's high speed digital photography system, we constructed a high speed digital imaging system for the observation of the sound source by incorporating an image recording system, an electrolaryngograph, and a high quality printer into the unit.In the examination of patients with esophageal phonation after laryngectomy, detailed observation and analysis from air swallowing to neoglottis formation, the formation of neoglottic mucosal vibrations, and the termination of phonation were possible. The mucosal vibration cycle was irregular, and its size differed among cycles. As its possible causes, a small amount of airflow for the hypopharyngeal mucosa, and inconsistent regulation by the inferior constrictor muscle of the pharynx were considered. For … More these conditions, there are rehabilitation plans such as increases in airflow retained in the esophagus, the ability to regulate intrathoracic pressure, and the ability to regulate the regulation ability of the inferior constrictor muscle of the pharynx.In patients who underwent hemilaryngectomy, the site of the sound source differed among patients. The sound source was present in the normal vocal cord, the area from the normal posterior portion of the vocal cord to the arytenoids area, or the normal false vocal cord. We speculated that the site of the neoglottis is determined by both the postoperative laryngeal morphology and the phonation method. Sound quality was the highest in patients showing normal vocal cord vibration. Therefore, to improve phonation function, a method in which air resistance is produced in the skin flap area opposite to the normal vocal cord. Since hyper-adduction of the vocal cord on the normal side or the false vocal cord causes forced hoarseness, phonation instructions for the effective use of expired air are also necessary. Less