2005 Fiscal Year Final Research Report Summary
Voice rehabilitation in patients who underwent laryngectomy
| Project/Area Number |
16300186
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Rehabilitation science/Welfare engineering
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| Research Institution | Nihon University |
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Principal Investigator |
MAKIYAMA Kiyoshi Nihon University, School of Medicine, Assistant Professor, 医学部, 講師 (00139172)
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| Co-Investigator(Kenkyū-buntansha) |
NIIMI Seiji International University of Health and Welfare, Speech Language Hearing Science, Professor, 言語聴覚センター, 教授 (00010273)
SASAKI Kenji Nihon University, School of Medicine, Professor, 教授 (30119961)
KIDA Akinori Nihon University, School of Medicine, Professor, 教授 (00096801)
YOSHIHASHI Hidetaka Nihon University, School of Medicine, Assistant Professor, 助手 (50328738)
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| Project Period (FY) |
2004 – 2005
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| Keywords | Neoglottis / High-speed imaging / Phonatory function / Alaryngeal speech / Voice onset / Normal larynx / Vocal source / Digital imaging |
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| Research Abstract |
The purposes of this study were to establish a method/apparatus for the physiological analysis of neogllotis in patients with severe dysphonia after laryngectomy, and to improve voice rehabilitation based on the results of data analysis.
Using a Kay's high speed digital photography system, we constructed a high speed digital imaging system for the observation of the sound source by incorporating an image recording system, an electrolaryngograph, and a high quality printer into the unit.
In the examination of patients with esophageal phonation after laryngectomy, detailed observation and analysis from air swallowing to neoglottis formation, the formation of neoglottic mucosal vibrations, and the termination of phonation were possible. The mucosal vibration cycle was irregular, and its size differed among cycles. As its possible causes, a small amount of airflow for the hypopharyngeal mucosa, and inconsistent regulation by the inferior constrictor muscle of the pharynx were considered. For
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these conditions, there are rehabilitation plans such as increases in airflow retained in the esophagus, the ability to regulate intrathoracic pressure, and the ability to regulate the regulation ability of the inferior constrictor muscle of the pharynx.
In patients who underwent hemilaryngectomy, the site of the sound source differed among patients. The sound source was present in the normal vocal cord, the area from the normal posterior portion of the vocal cord to the arytenoids area, or the normal false vocal cord. We speculated that the site of the neoglottis is determined by both the postoperative laryngeal morphology and the phonation method. Sound quality was the highest in patients showing normal vocal cord vibration. Therefore, to improve phonation function, a method in which air resistance is produced in the skin flap area opposite to the normal vocal cord. Since hyper-adduction of the vocal cord on the normal side or the false vocal cord causes forced hoarseness, phonation instructions for the effective use of expired air are also necessary. Less
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