老年期喉頭摘出者の代用音声獲得を困難にしている要因

抄録

Factor that complicate or aid substitute voice acquisition in older laryngectomee were investigated. 170 patients from a group of patients who underwent laryngectomy during the last three years in Tokyo served as subjects. The following items were analyzed: age, type of surgery, therapy (outpatient), participation in esophageal speech class, substitute voice acquisition, general health, restricted daily living activity, assistance from patients group, and self-esteem.
Approximately 30% of the patients acquired a substitute voice and were able to use it in their social life, and more than 60% of patients over 70 years-old quit attending classes. These patients experienced difficulty in communicating with their family members. Furthermore, the health of patients over 65 years-old who quit attending classes was poor. The sense of restricted daily living activity was especially high for quit attending classes due to factors such as, limited range of movement and stress from eating. It was thought that these are the factors that determine whether or not older patients attend voice classes.
Results of the present study suggest that it would be necessary to provide a voice rehabilitation program that is based on assessment by a medical team soon after surgery to minimize risks for each patients, and to establish an assistance system in which both medical professionals and patients group work together.