気管食道シャント発声の振動機構

Abstract

In tracheoesophageal (TE) shunt speech, the mucosal vibration in the pharyngoesophageal (PE) segment is considered to be the sound source but the mechanism of voice production is not clear. We studied the location and the movement of mucosal vibration at neoglottis in 12 TE speakers with X-ray fluoroscopy and strobofiberscopy.In 10 cases, two mucosal folds were observed in the PE segment; the upper one was the dorsal fold which protruded into the lumen at the orifice of the PE segment and the lower one was the circular fold just above the TE shunt. In 8 cases, periodical vibration was obtained at the upper fold with forward and backward closing. Among the 4 cases without periodical vibration, at the level of the neoglottis, the dorsal fold could not reach the ventral wall in 1 case and was in irregular contact with the ventral or lateral wall in 3 cases.We concluded that an adequate neoglottic closure is important for good mucosal vibration in TE shunt speech.