Avtor/Urednik		Šereg-Bahar, Maja; Hočevar-Boltežar, Irena; Jarc, Ana; Miklavčič, Tatjana; Soklič, Tanja; Aničin, Aleksandar; Fajdiga, Igor; Trček, Ciril; Šmid, Lojze; Župevc, Avgust; Žargi, Miha
Naslov		Dejavniki, ki vplivajo na učenje ezofagealnega govora
Prevedeni naslov		Factors influencing the learning of esophageal speech
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 43, št. Suppl 3
Leto izdaje		2004
Obseg		str. 249-52
Jezik		slo
Abstrakt		The possibilities of alaryngeal communication following laryngectomy include esophageal speech, electrolarynx and tracheoesophageal speech. The aim of this study was to determine the influence of various factors on the mastery of esophageal speech.124 patients were included in the study. They were treated for laryngeal (80 patients) or hypopharyngeal (44 patients) cancer between one and 20 years ago. The data on tumour localisation, extent and mode of treatment were obtained from the patients' medical documentation. The patients' motor capacity for articulation and the quality of their esophageal speech were assessed. The results were evaluated statistically using chi2-test and t-test, as well as linear and logistic regression. The tumour localisation (p < 0.01) and type of surgery (p < 0.001) are the most important factors influencing the mastery of esophageal speech. Velopharyngeal insufficiency is also a significant negative factor (p < 0.04). The motor capacity of the articulation organs is also important, but not significantly (p < 0.06). Mastery of esophageal speech is significantly lower (p < 0.002) in patients who had surgery less than 3 years ago. Location of the tumor in the hypopharynx is associated with a significantly lower probability that the patient will master esophageal speech. A normal motor capacity of articulation organs is needed for the acquisition of newly formed motor patterns that are necessary for mastering esophageal speech. Laryngectomees can successfully master this type of alaryngeal communication even several years after laryngectomy.
Izvleček		Načini govorne rehabilitacije po odstranitvi grla so: ezofagealni govor, uporaba umetnega grla ali vstavitev traheoezofagealne proteze. Želeli smo ugotoviti, kateri dejavniki pomembno vplivajo na uspešnost priučitve ezofagealnega govora. V raziskavo smo vključili 124 bolnikov, ki so bili operirani zaradi raka grla (80 bolnikov) ter raka spodnjega žrela (44 bolnikov). Iz medicinske dokumentacije smo povzeli podatke o lokalizaciji in razsežnosti tumorja ter načinu zdravljenja. Ocenili smo motorične sposobnosti artikulacijskih organov ter kakovost ezofagealnega govora. Rezultate smo vrednotili z hi2-testom in t-testom ter linearno regresijo in logistično regresijo. Najpomembnejši vpliv na uspešnost priučitve ezofagealnega govora imata lokalizacija tumorja (p < 0,01) ter vrsta operacije (p < 0,001). Tudi nepopolna velofaringealna zapora pomembno zmanjšuje uspešnost učenja ezofagealnega govora (p < 0,04). Motorika artikulacijskih organov je pomemben dejavnik, ni pa statistično značilen (p < 0,06). Čas od operacije statistično pomembno vpliva na uspešnost učenja ezofagealnega govora, saj so bolniki, operirani pred manj kot tremi leti, bistveno slabše svojili ezofagealni govor (p < 0,002). Lokalizacija tumorja v spodnjem žrelu predstavlja bistveno manjšo možnost za uspešno učenje ezofagealnega govora. Za pridobitev novih motoričnih vzorcev, potrebnih za ezofagealni govor, je nujna normalna motorika artikulacijskih organov. Bolniki z odstranjenim grlom se lahko uspešno naučijo tega načina sporazumevanja tudi več let po zdravljenju ob zadostni motivaciji in možnosti učenja.
Deskriptorji		LARYNGEAL NEOPLASMS LARYNGECTOMY SPEECH, ESOPHAGEAL HYPOPHARYNGEAL NEOPLASMS LARYNX, ARTIFICIAL