Voice rehabilitation in patients who underwent laryngectomy

本研究的目的是建立喉切除术后严重发声障碍患者新唇炎的生理分析方法/设备，并根据数据分析结果提高语音康复。我们利用凯氏高速数码摄影系统，结合影像记录系统、电喉仪和高品质打印机，构建了一个高速数字成像系统，用于观察声源。在喉切除术后食管发声患者的检查中，从吞咽空气到新咽形成、新咽粘膜振动形成、发声终止的详细观察和分析。粘膜振动周期不规则，周期大小不同。其可能的原因考虑为下咽黏膜气流少，咽部下缩肌调节不一致。对于这些情况，有一些康复计划，如增加保留在食道内的气流，调节胸内压力的能力，以及调节咽下收缩肌的调节能力。在接受半喉切除术的患者中，声源的位置在患者之间有所不同。声源存在于正常声带、正常声带后段至类蝶腺区或正常假声带。我们推测，新咽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，一种在正常声带对面的皮瓣区域产生空气阻力的方法。由于正常侧声带过度内收或假声带会导致强迫性声音嘶哑，因此有效利用过期空气的发声指导也是必要的。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