1991 Fiscal Year Final Research Report Summary
Fundamental Study of Artificial Larynx after Larngeal Resection
| Project/Area Number |
02670762
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Otorhinolaryngology
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| Research Institution | Kyoto University |
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Principal Investigator |
KOJIMA Hisayoshi Kyoto University, Otolaryngology, Assistant Professor, 医学部・耳鼻咽喉科, 講師 (10127079)
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| Co-Investigator(Kenkyū-buntansha) |
OMORI Koichi Kyoto University, Otolaryngology, Assistant Professor, 医学部・耳鼻咽喉科, 助手 (10233272)
NONOMURA Mitsuharu Kyoto University, Otolaryngology, Assistant Professor, 医学部・耳鼻咽喉科, 助手 (40218342)
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| Project Period (FY) |
1990 – 1991
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| Keywords | laryngeal carcinoma / voice rehabilitation / artificial laryux / total laryngectomy / partial laryngectomy / laryngeal pacing / laryngeal reconstruction / remobilization of thevocal cord |
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| Research Abstract |
Speech rehabilitation is important for the patients of laryngeal carcinoma after partial or total laryngectomy. The purpose of this research was to develop the new methods for speech rehabilitation and the new artificial larynx. At first, we analyzed the voice quality of the present methods after total laryngectomy. In esophageal speech, the intensity fluctuated widely and periodic vibration was obtained in few cases in contrast to tracheoesophageal shunt speech because the air flow was not enough for driving the mucosa of pharyngoesophageal segment. From these results, tracheoesophageal shunt speech with voice prostheses is one of the best method for vocal rehabilitate after total laryngectomy. We made it clear about the mechanism of vibration of tracheoesophageal shunt speech and devised the new surgical methods for improving the poor phonation cases.
From the view points of voice quality, vocal control and articulation, tracheopharyngeal shunt speech was considered to be the best method. We made the reed-fistula type artificial larynx of which sound source was inserted through the skin-hypopharynx shunt. This device was applied for clinical use and good voice quality was obtained. It is necessary for us to improve it to be transplanted for long-term in human body.
In partial laryngectomy, the key point is the reconstruction of the defect of the larynx. Thyroid gland flap, omohyoid muscle flap, and free mucosal transplantation were devised to correct the laryngeal defect. Utilization of the residual laryngeal function is also helpful for acquiring the good voice quality. Electrical pacing of the paralyzed vocal fold was performed successfully and dynamic reconstruction of the unilateral vocal fold paralysis was obtained clinically.
These results were considered to contribute to vocal rehabilitation after partial and total laryngectomy of the patients of laryngeal carcinoma.
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