全喉切除術後置入式氣管食道發聲瓣ProvoxTM之臨床經驗

The Clinical Experiences in Using a Self-retaining Voice Prosthesis Provox for Laryngectomized Patients

陳光超(Kuang-Chao Chen) ； 張學逸(Shyue-Yih Chang)

《中華民國耳鼻喉科醫學會雜誌》 29卷1期 (1994/02) Pp. 20-25

https://doi.org/10.6286/1994.29.1.20

摘要

自1980年Singer及Blom二氏發表了利用氣管食道發聲器為全喉切除病人做語音的復健後，各種氣管食道發聲器便不斷的被發展出來，而且在近十年來廣泛的被使用。這類氣管食道發聲器雖然可以使病人獲得不錯的音品質，但也各有缺點。為了改善這些問題，一種新型低氣流阻力，可自行固定的置入式氣管食道發聲器Provox便被發展出來，供全喉切除後病人使用。
我們自1991年起，對20名全喉切除病人，在全喉切術的同時，或是全喉切除之後，置入Provox。其中11例獲得良好的發聲，並持續在使用。另有9例不再使用Provox，大部份是因為病人在本研究初期未經適當選擇，如病人本身學習意原不高或是心理的問題而不再使用。在這20例病人中，只有少數曾有局部傷口的問題，沒有嚴重併發症發生，吞嚥及呼吸均無障礙。
因此我們認為只適當選擇病人，使用Provox應有相當高的成功率，值得推薦使用。

關鍵字

全喉切除 ； 氣管食道發聲器

並列摘要

In 1980, Singer and Blom first reported a prosthesis-assisted tracheo-esophageal puncture for speech rehabilita-tion after total laryngectomy. Since then, various types of voice prostheses have been developed and extensively utilized. Although these voice prostheses provide laryngectomee with satisfactory voice quai-ity, high air flow resistance of these device and patient-care diffictlties often pose problems. In order to avoid these problems, a new low-resistance, self-retain-ing voice prosthesis Provox was invented and has been employed. Since 1991, Provox has been installed in 20 laryngectomized patients. Patients. Eleven out of these patients have obtained good voice quality postoperatively and are still carry-ing their prostheses. The other 9 cases were reluctant to continue using Provox mainly due to their poor motivation or other psychologic problems. Except for some minor local wound problems there have been no complications in any of these 20 patients. Swallowing and respire-tory functions are normal in all of them. In our opinion, patient selection and education may be the most important success-determining factors for Provox utilization for post-layngectomy voice reha-bilitation.

並列關鍵字

total laryngectomy ； voice prosthesis