影响Blom-Singer发音管发声质量的原因分析

目的 了解影响Blom-Singer发音管发声障碍的各种相关因素。方法 回顾性分析1996年4月～2006年10月108例喉全切除术后行Blom-Singer发音管重建喉发声功能患者的临床资料，其中施行Ⅰ期Blom-Singer发声重建术96例，Ⅱ期Blom Singer发声重建术12例，并对其发声效果进行追踪观察。结果 96例行Ⅰ期发音管重建术中，22例发声质量差（22/96，23%）；12例行Ⅱ期发音管重建术中，8例发声质量差（8/12，67%）。两种术式的总失败率为（30/108，28%）。结论 Ⅰ期Blom-Singer发声重建术较Ⅱ期Blom-Singer发声重建术成功率高。术后发声质量的效果与环咽肌的处理、气管食管壁的完整性、气管造瘘口的大小、咽瘘、食管下咽腔狭窄及肺功能等因素密切相关。

Factors affecting pronunciation quality of the Blom-Singer pronunciation tube

Objective To explore relative factors affecting dysphonia of the Blom-Singer pronunciation tube. Methods The clinical data of 108 patients who had undergone Blom-Singer voice producing reconstruction following total laryngectomy were retrospectively analyzed. 96 cases received stage Ⅰ Blom-Singer voice producing reconstruction, and the other 12 cases underwent stage Ⅱ Blom-Singer voice producing reconstruction. Results 22 of 96 cases who had undergone stage Ⅰ Blom-Singer voice producing reconstruction had less effective phonation(22/96, 23%), and 8 of 12 cases who had undergone stage Ⅱ Blom-Singer voice producing reconstruction did not get the expected voice(8/12, 67%), and the total failure rate of the two operative methods was 28%. Conclusion The successful rate of stage Ⅰ Blom-Singer voice producing reconstruction was higher than that of the stage Ⅱ Blom-Singer voice producing reconstruction. Effect of voicing quality after the operations was closely related to following factors, such as treatments to the cricopharyngeal muscle, integrity of the tracheo esophagus wall, size of the trachea stoma, pharyngeal fistula, stenosis of the esophagus hypo-pharyngeal cavity and pulmonary function of patients.