气管食管裂隙状瘘发音重建术的声学分析

目的 客观评价气管食管裂隙状瘘发音重建术后的发音效果，并以此指导临床工作。方法 对喉全切除术后I期与Ⅱ期气管食管裂隙状瘘发音患者、食管发音患者、安装Blom—Singer发音钮患者以及健康人分别进行语音测试，分析7项客观声学参数，比较发音效果。结果 经统计学t检验，气管食管裂隙状瘘语音最长发音时间短于健康人，明显长于食管音，但和Blom—Singer发音钮语音差异无显著性；其声音的强度和健康人及Blom—Singer发音钮差异无显著性，明显高于食管音；其基频明显低于健康人；其频率微扰和振幅微扰明显高于健康人，而明显低于食管发音，与Blom—Singer发音钮语音差异无显著性；其共振峰频率和能量仅在F1共振峰能量上明显高于食管音，其余各频率上差异均无显著性。虽然喉全切除I期气管食管裂隙状瘘发音重建术中制作帽状气室，而Ⅱ期发音重建术中不制作帽状气室，但两者语音声学分析各参数间差异均无显著性。结论气管食管瘘语音比食管音接近健康人语音，能满足日常生活需要。气管食管裂隙状瘘发音重建术中不制作帽状气室不影响术后的发音。

Acoustic analysis of the voice restored by using a tracheoesophageal slit-like fistula]

OBJECTIVE: To evaluate the quality of voice restored by using a tracheoesophageal slit-like fistula objectively through acoustic analysis. METHODS: Seven objective voice parameters (fundamental frequency, intensity, duration, formant F1, F2, F3 and their energy, jitter, and shimmer) of esophageal speech, Blom-Singer prosthesis voice, tracheoesophageal slit-like fistula voice, primary or modified surgical restored, and normal voice were analyzed and compared. RESULTS: T test was used for statistical analysis. The maximum phonation time of slit-like fistula voice was shorter than that of normal voice, longer than that of esophageal voice, no significant difference compared with that of Blom-Singer prosthesis voice. Its sound intensity of it was similar to that of normal voice and Blom-Singer voice, better than that of esophageal voice. Its fundamental frequency was lower than that of normal voice. Its shimmer and jitter was more than that of normal voice, less than that of esophageal voice, and similar to that of Blom-singer one. Compared with esophageal voice, all formants but F1 of it were not statistically different. No statistical difference between the 2 groups of slit-like fistula patients, i.e., the instant slit-like fistula construction after total laryngectomy and the second stage slit-like fistula construction. CONCLUSION: The voice quality of the patients with tracheoesophageal slit-like fistula is similar to that of the normal and could meet the needs of daily life.