Рехабилитацията на гласа е едно от най-сериозните предизвикателства пред болните с ларингектомия по повод на злокачествено заболяване. Целта на настоящото съобщение е да се анализира литературата върху приложението на гласовите протези при такива болни и да се представят основните им особености, предимства и недостатъци. Проведено е ретроспективно проучване на публикациите върху гласовите протези, реферирани в базата-данни MEDLINE през последните години и е анализирано съдържанието на обзорните статии. Вече са налице над 1900 статии, посветени на рехабилитацията на гласа с гласови протези, като първите от тях са на Е. Mozolewski (Полша) от 1978 г. Съвременните протези са от два типа: „преживяващи“ и „непреживяващи“. Първите се поставят само от специалист. Ползват се от няколко седмици до 2 години, след което се подменят. Описват се конкретните характеристики, начините на поставяне и поддръжка, както и предимствата и недостатъците на отделните модели. Цената им е все още висока, което ще наложи да се реинбурсират от здравната каса. Внедряването на гласовите протези в ларингологичната практика у нас ще допринесе съществено за подобряване на индивидуалното качество на живот на ларингектомираните болни, постигнато в другите страни.
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Voice rehabilitation is one of the most serious challenges faced by the patients laryngectomized on the occasion of a malignant disease. The purpose of the present communication was to analyze the literature devoted to the application of the voice prostheses in such patients as well as to present their basic peculiarities, advantages, and disadvantages. A retrospective search of the publications on the voice prostheses abstracted in MEDLINE data-base during the recent years was carried out and the content of the review articles was analyzed. There were already more than 1900 articles devoted to voice rehabilitation by means of voice prostheses as the first ones were authored by Е. Mozolewski (Poland) in 1978. Contemporary prostheses are of two types, i. e. ‘indwelling’ and ‘non-indwelling’. The first ones should be placed by a specialist only. They can be used for several weeks up to 2 years and should be changed thereafter. The concrete characteristics, ways of placement and maintenance, as well as the advantages and disadvantages of the single models were described. Their price still remains high which will necessitate their reimbursement by the Health Insurance Fund. Introduction of the voice prostheses into the laryngological practice in our country will substantially contribute to the improvement of the individual quality of life of the laryngectomized patients that has already been achieved in the other countries.
Azevedo, E. H., N. Montoni, J. Gonçalves Filho, L. P. Kowalski, E. Carrara-de Angelis. Vocal handicap and quality of life after treatment of advanced squamous carcinoma of the larynx and/or hypopharynx.- J. Voice, 26, 2012, No 2, e63-71.
Balm, A. J., M. W. van den Brekel, I. B. Tan, F. J. Hilgers. The indwelling voice prosthesis for speech rehabilitation after total laryngectomy: a safe approach.- Otolaryngol. Pol., 65, 2011, No 6, 402-409.
Chen, A. Y., S. Fedewa, J. Zhu. Temporal trends in the treatment of early- and advanced-stage laryngeal cancer in the United States, 1985-2007.- Arch. Otolaryngol. Head Neck Surg., 137, 2011, No 10, 1017-1024.
Dassonville, O., J. C. Mérol, A. Bozec, F. Swierkosz, J. Santini, A. Chaïs, P. Y. Marcy, P. Giacchero, E. Chamorey, G. Poissonnet. Randomised, multi-centre study of the usefulness of the heat and moisture exchanger (Provox HME®) in laryngectomised patients.- Eur. Arch. Otorhinolaryngol., 268, 2011, No 11, 1647-1654.
Deore, N., S. Datta, R. C. Dwivedi, R. Palav, R. Shah, S. I. Sayed, M. Jagde, R. Kazi. Acoustic analysis of tracheo-oesophageal voice in male total laryngectomy patients.- Ann. R. Coll. Surg. Engl., 93, 2011, No 7, 523-527.
Deschler, D. G., K. S. Emerick, D. T. Lin, G. W. Bunting. Simplified technique of tracheoesophageal prosthesis placement at the time of secondary tracheoesophageal puncture (TEP).- Laryngoscope, 121, 2011, No 9, 1855-1859.
Ellis, L., B. Rachet, M. Birchall, M. P. Coleman. Trends and inequalities in laryngeal cancer survival in men and women: England and Wales 1991-2006.- Oral Oncol., 48, 2012, No 3, 284-289.
Garavello, W., F. Turati, C. Bosetti, R. Talamini, F. Levi, E. Lucenteforte, F. Chiesa, S. Franceschi, C. La Vecchia, E. Negri. Family history of cancer and the risk of laryngeal cancer: a case-control study from Italy and Switzerland.- Int. J. Cancer, 130, 2012, No 3, 665-670.
Giordano, L., S. Toma, R. Teggi, F. Palonta, F. Ferrario, S. Bondi, M. Bussi. Satisfaction and quality of life in laryngectomees after voice prosthesis rehabilitation.- Folia Phoniatr. Logop., 63, 2011, No 5, 231-236.
Graville, D. J., A. D. Palmer, P. E. Andersen, J. I. Cohen. Determining the efficacy and cost-effectiveness of the ActiValve: results of a long-term prospective trial.- Laryngoscope, 121, 2011, No 4, 769-776.
Harms, K., W. J. Post, K. T. van de Laan, F. J. van den Hoogen, S. E. Eerenstein, B. F. van der Laan. A prospective randomized multicenter clinical trial of the Provox 2 and Groningen Ultra Low Resistance voice prostheses in the rehabilitation of post-laryngectomy patients: a lifetime and preference study.- Oral Oncol., 47, 2011, No 9, 895-899.
Holmes, A. R., K. Chong, E. Rodrigues, R. D. Cannon, E. Carpenter, D. R. Ruske, P. J. Dawes. Yeast colonization of voice prostheses: pilot study investigating effect of a bovine milk product containing anti-Candida albicans immunoglobulin A antibodies on yeast colonization and valve leakage.- Ann. Otol. Rhinol. Laryngol., 121, 2012, No 1, 61-66.
Kapila, M., N. Deore, R. S. Palav, R. A. Kazi, R. P. Shah, M. V. Jagade. A brief review of voice restoration following total laryngectomy.- Indian J. Cancer, 48, 2011, No 1, 99-104.
Moukarbel, R. V., P. C. Doyle, J. H. Yoo, J. H. Franklin, A. M. Day, K. Fung. Voice-related quality of life (V-RQOL) outcomes in laryngectomees.- Head Neck, 33, 2011, No 1, 31-36.
Pantel, M., O. Guntinas-Lichius. Laryngeal carcinoma: epidemiology, risk factors and survival.- HNO, 60, 2012, No 1, 32-40.
Reumueller, A., M. Leonhard, G. Mancusi, J. N. Gaechter, W. Bigenzahn, B. Schneider-Stickler. Pharyngolaryngectomy with free jejunal autograft reconstruction and tracheoesophageal voice restoration: Indications for replacements, microbial colonization, and indwelling times of the Provox 2 voice prostheses.- Head Neck, 33, 2011, No 8, 1144-1153.
Xi, S. Effectiveness of voice rehabilitation on vocalisation in postlaryngectomy patients: a systematic review.- Int. J. Evid. Based Healthc., 8, 2010, No 4, 256-258.
