Success and predictability of provox prosthesis voice rehabilitation.
Success and predictability of provox prosthesis voice rehabilitation.
复制标题
Provox 假肢发声康复的成功和可预测性。
DOI：
10.1001/archotol.128.6.687
复制
发表时间：
2002
期刊：
影响因子：
--
通讯作者：
P. Zbären
中科院分区：
文献类型：
--
作者：
M. Hotz;A. Baumann;I. Schaller;P. Zbären
目标
目的：探讨发声功能康复的成功率及相关临床因素，分析多维Harrison-Robillard-Shultz气管食道穿刺量表(HRS评定量表)的辨别能力。
设计
前瞻性临床研究。
设置
瑞士伯尔尼英塞尔斯皮特大学医院耳鼻咽喉头颈外科。
研究对象和方法
从1992年到1998年，87例晚期喉和/或下咽鳞状细胞癌患者在全喉切除术后行一期气管-食道穿刺术。临床医生、耳鼻咽喉科医生和言语/语言病理学家分别使用HRS评分表评估发音假体康复的成功率。
结果
年龄、性别、肿瘤部位、肿瘤分期和放射治疗对发音假体修复的成功率无影响。总体而言，语音康复成功率在40%到62%之间。语音/语言病理学家和临床耳鼻喉科医生对同一组患者进行了评估，没有显著的统计学差异。HRS评定量表分析表明，功能说话人和非功能说话人的子量表参数CARE分布均匀，且子量表参数质量与使用之间存在很强的相关性。
结论
由于其安全性和简便性，气管-食道穿刺术已成为全喉切除术后最先进的发音康复方法。从两种方法的远期成功率来看，发音假体在发音康复方面的短期优势优于食道发音康复。
OBJECTIVES
To determine the success rate and relating clinical factors of voice prosthesis rehabilitation and to analyze the discrimination ability of the multidimensional Harrison-Robillard-Shultz Tracheoesophageal Puncture Rating Scale (HRS Rating Scale).
DESIGN
Prospective clinical study.
SETTING
University Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Inselspital, Bern, Switzerland.
SUBJECTS AND METHODS
From 1992 through 1998, 87 patients with advanced squamous cell carcinoma of the larynx and/or hypopharynx underwent primary tracheoesophageal puncture after total laryngectomy. Clinician otolaryngologists and speech/language pathologists independently used the HRS Rating Scale for success assessment of voice prosthesis rehabilitation.
RESULTS
Age, sex, tumor localization, tumor stage, and radiation therapy had no influence on the success of voice prosthesis rehabilitation. Overall, voice rehabilitation success rates between 40% and 62% were achieved. Speech/language pathologists and clinician otolaryngologists evaluated the same patient group without significant statistical differences. The HRS Rating Scale analysis showed an equal distribution of the subscale parameter care in functional and nonfunctional speakers and a strong correlation between the subscale parameters quality and use.
CONCLUSIONS
Because of its safety and simplicity, tracheoesophageal puncture has become a state of the art method for voice rehabilitation after total laryngectomy. The short-term superiority of voice prosthesis in voice rehabilitation over esophageal speech rehabilitation must be seen in light of comparable long-term success rates of the 2 methods.