Voice function and quality of life in laryngectomees

摘要: Individuals who undergo laryngectomy, surgical removal of the larynx, loose their normal voice. The breathing pattern is altered to permanent tracheostomal breathing. A new voice can be established by use a segment in lower part pharynx and most upper esophagus, pharyngo-esophageal (PE) segment. This source tracheoesophageal (TE) speech esophageal (E) speech. Electrolaryngeal (EL) an alternative speaking technique. overall aim this thesis was describe function effects PEsegment with endoscopic radiological methods, make acoustical audio-perceptual analyses laryngectomees’ speech, investigate self-evaluations quality life. Fifty-four laryngectomees participated four studies, all 45 TE-speakers, E-speakers five EL-speakers. PE-segment studied high-speed imaging recordings videoradiography. Analyses were made vibratory pattern, shape, placement size PE-segment. Recorded samples perceptually acoustically analysed. Voice problems evaluated Handicap Index (VHI) health-related life investigated questionnaires from European Organization for Research Treatment Cancer (EORTC). Volitional control musculature seen (study I). In voiceless consonants vibrations ceased opening gesture observed during closure duration. voiced consonants, continued, although decreased amplitude compared surrounding vowels. These findings should useful therapeutic intervention regarding coordination phonation articulation. Videoradiographical changes showed predominant pharyngeal posterior wall II). physiological measurements interindividual variations both silence. Both TEand able good between anterior phonation. Placement relation cervical column varied C4 C7. There no significant relationships PE-segment, perceptual quality, fundamental frequency intensity. study IV, mean values intensity TE-speakers close normative data, however wide inter-speaker ranges. Speaking rate many slow, phrase lengths short percent pause time high, likely due deviant breath manual stoma occlusion. Protocols using visual analogue scales ratings TE-speech proved reliable carefully designed speech-language pathologist ratings. Low pitch, low rates affected assessments degree deviation, these parameters significantly related assessments. functional physical subscales VHI relationship intensity, total reading time, length time. emotional subscale measurements. Perceptual speakers’ self-reported handicap. III, handicap moderate more than 50 patient group. About one third group rated as severe. Scores somewhat higher scale. Ratings on EORTC-questionnaire scores agreement data. Global life-scale (Global QOL) considerably EORTCquestionnaire also revealed smell taste, coughing, xerostomia. participants’ scoring QOL EORTC-questionnaire. VHIscores EORTC-scores problems, social contact, pain head neck area, meal situations. confirm that perceived affects laryngectomee’s participation activities. As conclusion, combination VHIquestionnaire recommended. Additional questions breathing, mucus production coughing needed complete documentation laryngectomees.