ISSN:0023-852X    

DOI:10.1288/00005537-197504000-00001

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractThis study was undertaken to provide information on the voice of patients following radiotherapy for glottic cancer. Part I presents findings from questionnaires returned by 227 of 235 patients successfully irradiated for glottic cancer from 1960 through 1971. Part II presents preliminary findings on the speaking fundamental frequencies of 22 irradiated patients.Normal to near‐normal voice was reported by 83 percent of the 227 patients; however, 80 percent did indicate persisting vocal difficulties such as fatiguing of voice with much usage, inability to sing, reduced loudness, hoarse voice quality and inability to shout. Amount of talking during treatments appeared to affect length of time for voice to recover following treatments in those cases where it took from nine to 26 weeks; also, with increasing years since treatment, patients rated their voices more favorably. Smoking habits following treatments improved significantly with only 27 percent smoking heavily as compared with 65 percent prior to radiation therapy. No correlation was found between smoking (during or after treatments) and vocal ratings or between smoking and length of time for voice to recover. There was no relationship found between reported vocal ratings and stage of the disease.Data on mean speaking fundamental frequency seem to indicate a trend toward lower frequencies in irradiated patients as compared with normals. A trend was also noted in both irradiated and control groups for lower speaking fundamental frequencies in heavy smokers compared with non‐smokers or previous smokers. These trends would indicate some vocal cord thickening or edema in irradiated patients and in heavy smokers.It is suggested that the study of irradiated patients' voices before, during and following treatments by means of audio, aerodynamic and acoustic instrumentation would yield additional information of diagnostic value on recovery of laryngeal function. It is also suggested that the voice pathologist could assist in evaluating and guiding patients in vocal usages during and following treatme

ISSN:0023-852X    

DOI:10.1288/00005537-197504000-00002

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe published literature contains relatively few references to vocal rehabilitation for persons with partial laryngectomy. Articles on various types of surgery indicate that many individuals develop satisfactory voice following limited surgery, particularly supraglottic procedures. An informal questionnaire completed by 10 laryngologists who had had substantial experience with sub‐total laryngectomy revealed that an average of 25 percent of their patients with laryngeal cancer receive partial laryngectomy. Lesions limited to the epiglottis, supraglottic areas or one vocal cord are regularly treated by limited excision. Half of the questionnaires indicated that partial laryngectomy can be used for bilateral vocal cord lesions under certain circumstances. The questionnaire confirmed the published reports that most of the subsequent voices were satisfactory or good and many recover without special vocal retraining. None reported employment of partial laryngectomy for sub‐glottal cancer. Hemilaryngectomy and cordectomy frequently resulted in some impairment of voice. Speech therapy is often recommended when possible.Therapy applicable to voice following partial laryngectomy combines five emphases:1.strengthening glottic closure and loudness of the voice;2.improving the efficiency of breath expenditure;3.increasing the articulately skill and intelligibility of speech;4.recognizing and compensating for hearing loss; and5.aiding the patient to reduce detrimental environmental influences and to adjust to his environmental requireme

ISSN:0023-852X    

DOI:10.1288/00005537-197504000-00003

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractThis paper presents the results of conservative operations on patients with laryngeal carcinoma in the ENT Department of the University Hospital “Dr. Mladen Stojanovic,” Zagreb, Yugoslavia, during the last 20 years. The authors have evaluated the functional results after partial vertical and horizontal surgical interventions on the larynx and after the reconstruction of the larynx following these operations. Functional analysis of the voice was performed by stroboscopic, indirect microlaryngostroboscopic and sonagraphic examinations of the laryngeal function, as well as by the spirometric analysis of the respiratory potential of these patients, especially the degree of obstruction of the upper respiratory tract and changes on the cardiovascular system. Attention has been given likewise to the examination of the act of swallowing, especially after horizontal partial resections of the larynx. Radiography and radiocinematography was used for these examinations. Based on this research the authors have formulated new conceptions and opinions about the voice genera

ISSN:0023-852X    

DOI:10.1288/00005537-197504000-00004

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractLaryngeal cancer, though not high in incidence, may have a devastating effect on the affected individuals' total adjustment. Esophageal speech, while a desirable form of substitute speech, cannot be learned by all, thus requiring a re‐evaluation of the artificial larynx and consideration of such special operations as that of Dr. Ryoso Asai. The acoustical characteristics and deficiencies of all pseudo voices are stated and discussed. The female voice is generally identified as such. Methods for the prognosis of learning speech include a systemic questionnaire for pre‐evaluation which was based on behavior patterns of the laryngecto

ISSN:0023-852X    

DOI:10.1288/00005537-197504000-00005

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe normal course of speech acquisition after laryngectomy is described, with emphasis on the initial stage. Factors that favor or thwart the training process are discussed and particular methods applied when functional or organic impediments deviate or block the development of esophageal speech. A few remarks are added on the rehabilitation after extended forms of surgery and on the use of the artificial larynxes.

ISSN:0023-852X    

DOI:10.1288/00005537-197504000-00006

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractSome aspects of speech deficiency in Japanese‐speaking patients who had undergone surgeries for laryngeal malignancy were studied. Surgical procedures included reconstructive surgeries after total laryngectomy and conservation surgeries. A series of listener‐judgments and some acoustic analyses of speech were made. The recorded voices of the patients were more or less hoarse. The median speaking pitch varied greatly from patient to patient, and often assumed an unusual value. The average articulation score for five Japanese vowels was computed for each subject. The score varied from patient to patient, and was thought to be useful in quantitatively evaluating speech quality. It was shown that certain glottal consonants such as /h/ can be affected by laryngeal surgeries. It was emphasized that the larynx should be regarded not only as a generator or a vibrator, but also as an articulator which produces consonants. The listening tests also revealed that the intonation pattern of Japanese two‐syllable nouns can be influenced by laryngeal surgeries, and that distinction among certain words may become impossible as a result. This type of speech problem may require serious consideration in some language environ

ISSN:0023-852X    

DOI:10.1288/00005537-197504000-00007

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

摘要:

AbstractSimultaneous video‐fluoroscopy and fiber‐optic video laryngoscopy was carried out on a series of eight laryngectomees. Previous concepts supported by an earlier report1 indicated that the folds of the rebuilt cricopharyngeal sphincter were seen to represent the primary source of sound vibration for voice production. Fold vibration was envisioned as an essential for sound production. Present findings present a challenge to the older concept.The fluoroscopic studies showed a considerable variation in the vertical thickness of the sphincteric area — from several millimeters to as many as 10 centimeters. Mucus bubbles in rapid motion were easily visible immediately above the narrowest portion of the reconstructed cervical esophagus. Ingestion of barium only enhanced the visualization of this bubbling. Vibration of a long vertical area of the thin anterior and thicker posterior esophageal walls well above and well below this point was regularly noted.Fiber‐optic visualization failed to show actual fold vibration at any time. Momentary opening of the food tract during air injection or intake, immediately prior to the onset of phonation, was seen on many occasions. During phonation, routinely, the anticipated pseudoglottic opening was obscured by bubbles of mucus or barium. These findings suggest that the air, when accumulated below the narrowest spot in the hypopharyngeal‐esophageal tract and when forced upward through a narrow opening, sets the accumulated mucus, not the mucous membrane, into vibration; further, that this vibration is of sufficient amplitude to transmit itself to both the anterior wall and the posterior wall of an extensive vertical portion of

ISSN:0023-852X    

DOI:10.1288/00005537-197504000-00008

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197504000-00009

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197504000-00010

出版商:John Wiley&Sons, Inc.    

年代:1975

数据来源: WILEY