Total Laryngectomy Postoperative The Upper Esophagus Air Flow, Pressure, Acoustic Intensity Correlation

Objective Pronunciation reconstruction after total laryngectomy patients who failed tocarry out aerodynamic parameters-gas flow, pressure, sound intensity measurement, analysisthe correlation between the three, the theoretical basis for the development of new voice, andto promote use the sounder.Methods The object of this study to select subjects from March1994to October2006treatment at the Ningxia Medical University General Hospital Department of Otolaryngology-Head and Neck Surgery, pathological diagnosis is carcinoma of larynx, parallel totallaryngectomy, the follow-up are still alive58patients, still have their own pronunciationdesire or willingness to improve their quality of life, consent of the subjects met the inclusioncriteria of15cases, sensitive gag reflex failed to successful completion of the test subjects4cases, and ultimately the successful completion of the test subjects11cases, measuredhypopharynx pressure, pressure in the esophageal inlet below1cm not pronunciation, soundpronunciation under different flow pressure and intensity when pronunciation.Results⑴subjects the hypopharynx pressure value and esophageal entrance1cmbelow the pressure value of not pronunciation were (0.73±1.85) mmHg and (13.91±8.35)mmHg, P <0.01,the difference was statistically significant.⑵subjects hypopharynx pressurevalue and to give1L/min oxygen flow to under pronunciation when the pressure values were(0.73±1.85) mmHg and (43.07±10.31) mmHg and P <0.01,the difference was statisticallysignificant.⑶subjects esophageal entrance1cm below the pronunciation and give1L/minoxygen flow under the pronunciation of pressure, P <0.01,the difference was statisticallysignificant. Pressure values and pressure values give2L/min oxygen flow pronunciation⑷subjects esophageal entrance1cm below give1L/min oxygen flow to pronounce,(43.07± 10.31)mmHg and (45.18±11.48)mmHg, P>0.05,the difference was not statisticallysignificant.⑸subjects esophageal inlet below1cm is not pronounced when given under thepronunciation of2L/min oxygen flow pressure, P<0.01,the difference was statisticallysignificant.⑹subjects esophageal inlet below1cm give1L/min pronunciation of oxygenflow stress and pronunciation sound intensity values were (39.33±4.04) mmHg and (68.08±2.70) dB, r=0.279, P>0.05, wireless related.(7)1cm give2L/min oxygen flow pronunciation,stress and pronunciation sound intensity values were (41.00±3.61) mmHg and (68.08±2.70)dB, r=0.617, P>0.05wireless related.Conclusion1、Seen significant pressure in the one above the esophageal inlet(hypopharynx) and esophagus entrance1cm below the pronunciation is poor, this pressuredifference is the impact of the bottom of the esophagus entrance less than the1cm similarvocal cord mucosa of the power, gas storage is source of the esophageal speech aid appliance.2、The pressure is too small or too big not push the esophageal the entrance mucosa and sound.The pressure is too small because they can not promote the mucosa of the esophagus entrancebut not voice; The pressure is too big can lead to the pharyngeal constrictor muscle spasm andnot promote esophageal the entrance mucosa vibration sound, or leakage of gas stored in gasstorage chamber through the bottom of the esophagus into the stomach.3、The size of theflow of oxygen and the pressure changes of the bottom of esophageal inlet are not statisticallysignificant. That is given regardless of how much oxygen flow, no significant change in theesophageal tone to help voice pronunciation quality.4、Esophageal inlet1cm below thepronunciation, the pressure and sound intensity are not linear correlation, sound intensity isnot increased with the pressure enhanced. The study found that increase of sound intensityrelated to not only the pressure but also the resistance of the mucosa and esophageal inlet airflow.