治疗装置作为促进食管发声获得的辅助资源

文献信息

中文摘要

目的： 描述使用直接食管刺激治疗装置的研究结果，该装置可促进食管发声的产生。
方法： 15名全喉切除受试者参与研究，这些受试者均无发声能力，且传统言语-语言病理学疗法在食管发声获得方面未取得成功。在12次使用该装置进行食管刺激之前和之后，受试者接受了针对全喉切除的特定嗓音质量方案、视频荧光透视检查和嗓音自评问卷调查。为刺激食管发声获得，使用总长度为50厘米的导管进行直接食管刺激，导管从鼻孔插入直至到达咽食管段；导管另一端固定于气管造口。干预连续进行12周，无中断。采用描述性和推断性统计分析，显著性水平为5%。
结果： 9名（60%）受试者发展出有效的食管发声用于交流，而6名（40%）受试者成功发展出食管声音。听觉感知评估未显示干预前后时刻之间存在统计学显著差异；然而，参与者的自评表明其感知到嗓音质量有所改善。
结论： 使用所提出装置进行食管刺激与患者自评改善相关，并使一部分受试者实现功能性食管发声。该装置可能是一种可行的治疗资源。
证据等级： 2B - 无对照组的前瞻性干预研究。

英文摘要

OBJECTIVE: To describe the findings on the use of a therapeutic device for direct esophageal stimulation, which facilitates the production of the esophageal voice.
METHOD: Fifteen total laryngectomized subjects, with no voice production and no success in traditional speech-language pathology therapies for esophageal voice acquisition, participated. Subjects were evaluated using a specific vocal quality protocol for total laryngectomy, videofluoroscopy, and a vocal self-assessment questionnaire before and after 12 sessions of esophageal stimulation with the device. To stimulate esophageal voice acquisition, direct esophageal stimulation was performed using a catheter with a total length of 50 cm, which was introduced from the nostril until reaching the pharyngoesophageal segment; the other end of the catheter was fixed to the tracheostoma. The intervention occurred over 12 consecutive weeks, without interruption. Descriptive and inferential statistical analysis was performed at a 5% significance level.
RESULTS: Nine (60%) subjects developed effective esophageal voice for communication, while 6 (40%) managed to develop esophageal sound. Auditory-perceptual evaluation did not show statistically significant differences between pre- and post-intervention moments; however, participants' self-assessment indicated perceived improvement in vocal quality.
CONCLUSION: Esophageal stimulation with the proposed device was associated with improvements in patients' self-assessment and enabled a proportion of subjects to achieve functional esophageal voice. The device may represent a feasible therapeutic resource.
LEVEL OF EVIDENCE: 2B - Prospective interventional study without control group.