| Project/Area Number |
10838042
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
リハビリテーション科学
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| Research Institution | Nihon University |
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Principal Investigator |
KAMETANI Ryuichi (1999) Nihon University, School of Medicine, Associate Professor, 医学部, 講師 (30256862)
島崎 奈保子 (1998) 日本大学, 医学部, 助手 (50267085)
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| Co-Investigator(Kenkyū-buntansha) |
NOZAKI Motohiro Tokyo Wemen's Medical University, School of Medicine, Professor, 医学部, 教授 (70086586)
NIIMI Seiji The University of Tokyo, Graduate School of Medicine, Professor, 大学院・医学研究科, 教授 (00010273)
MAKIYAMA Kiyoshi Nihon University, School of Medicine, Associate Professor, 医学部, 講師 (00139172)
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| Project Period (FY) |
1998 – 1999
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| Project Status |
Completed (Fiscal Year 1999)
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| Budget Amount *help |
¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 1999: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1998: ¥1,100,000 (Direct Cost: ¥1,100,000)
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| Keywords | Laryngectomized patients / Voice reconstruction / Neoglottis / T-E shunt / Esophageal speech / High-speed digital imaging system / 喉頭全摘出術 / 頭剄部癌 |
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| Research Abstract |
In this study, we investigated neoglottic vibration in laryngectomized patients using high-speed ditial image recording System. The information about the location and movements of the neoglottis is essential to determine the best reconstruction material and the best surgical procedure for voice restoration in patients with head and neck cancer. The high-speed digital imaging system consits of a laryngeal endoscope and an image sensor. The present system takes 4,500 pictures per second.
The first group underwent total laryngectomy. The hypopharyngeal mucosa above the esophageal entrance plays the role of the neoglottis of the esophageal speech. The mucosal surface of the neoglottis protrudes like a valve and vibrates. The second group underwent laryngopharyngoesophagectomy with a free jejunal graft : elephant type shunt. This technique minimizes the length of intestinal tract which is sacrificed and uses a free jejunal graft to create an elephant-type shunt aimed at improving the chance for successful voice restoration. Mucosal vibration is seen in the lumen of the jejunum. In contrast to esophageal speech, the neoglottis remains open during phonation with elephant-type shunt speech. We consider that when the expiratory air passes through the shunt to the jejunal lumen, the locla mucosa is sucked by the Bernoulli effect to serve as a sound source. In patients using esophageal speech, voice control is performed by the neoglottis. The control is considered to be possible due to the preservation of the pharyngeal muscles. Mucosal vibration is also observed in this patient. Voice with esophageal speech sounds close to the normal voice produced by the larynx. In patients using elephant-type shunt speech, however, the neoglottis may be created by an aerodynamic force. We consider that the location of the neoglottis is passively determined by the expiratory airflow and size of the jejunal lumen.
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