喉全切除患者应用低阻力型Groningen发音假体的空气动力学研究

目的研究应用于患者的低阻力型Groningen发音假体的空气动力学特性及机制。方法应用荷兰Groningen大学研制的空气动力学测量仪，采用重复测量，对24例喉全切除后安装低阻力型Greningen发音假体的患者进行同步测量发音时的声压级（sound pressure level）、气管内压力（pressure）及假声门上的气流率（flowrate）等三个参数，其中6例更换过发音假体，对他们使用的两个假体都进行了测量，分析各参数间的关系。结果24例患者应用发音假体重复测量得出180组数据，经过数据筛选174组数据的声压级中位数为88．0dB，气管内压力中位数为73．6cmH2O（1cmH2O=0．098kPa），假声门上气流率中位数为123．2ml／s。30例次患者发音时的声压级与气管内压力无相关性（r=-0．058，P〉0．05），与假声门上的气流率也无相关性（r=-0．119，P〉0．05），气管内压力与假声门上的气流率呈正相关（r=0．699，P〈0．05）。结论当假声门下气流使假声门产生振动后，再增加假声门下气流并不能使假声门振动幅度加大，因此，发音响度也不会增加。

Aerodynamic study of the low-resistance Groningen button in voice prosthesis

OBJECTIVE: To study the aerodynamic characteristics of low-resistance Groningen voice prosthesis for total laryngectomees and the related clinical significance. METHODS: Three aerodynamic parameters were measured in 24 laryngectomees implanted with low-resistance Groningen voice prosthesis: the sound pressure level (SPL), intratracheal pressure (pressure) and airflow rate (flowrate). Among them, 6 cases were initially implanted with other prosthesis which was replaced by the Groningen buttons later. The parameters were measured for both old and new prosthesis. The relationship between the variables were computed with means of Pearson' s product-moment correlations. RESULTS: The parameters were measured repeatedly among all cases, 180 group data were collected. Screening test showed that the median of sound pressure level, intratracheal pressure and airflow rate are respectively 88.0 dB, 73.6 cm H2O (1 cm H2O = 0.098 kPa) and 123.2 ml/s. Thirty times measurement of patients phonation showed that the correlation between SPL and pressure was not significant (r = -0.058, P > 0.05). The relationship between flow rate and SPL was not significant(r = -0.119, P > 0.05). The correlation between pressure and flow rate was significant(r = 0.699, P < 0.05). CONCLUSIONS When pseudoglottis vibration is produced by sub pseudoglottis air flow, pseudoglottis vibration and voice loudness can not be increased by continuous air flow.