Tracheoesophageal Voicing Following Resistance-Based Dysphagia Rehabilitation: An Exploratory Multidimensional Assessment

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-03-25 DOI:10.1002/hed.28136

Marise Neijman, Klaske E. van Sluis, Rob J. J. H. van Son, Martijn M. Stuiver, Frans J. M. Hilgers, Michiel W. M. van den Brekel, Maarten J. A. van Alphen, Lisette van der Molen

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Abstract

Background

This exploratory study investigated tracheoesophageal voicing following 6 weeks of resistance-based dysphagia rehabilitation with the SEA2.0, using a multidimensional assessment approach.

Methods

Twenty laryngectomized participants were assessed at T0 (baseline), T1 (after 6 weeks training), and T2 (after 8 weeks rest). Training included the chin tuck, jaw opening, and effortful swallow against resistance. Multidimensional assessments included acoustic analysis (AVQI, intensity, dynamic range), clinician-rated perceptual evaluations (voice tonicity, intelligibility), PROMs (VHI-10, V-RQOL, CPIB-10), and tracheal manometry and pharyngeal-/esophageal high-resolution impedance manometry during voicing.

Results

No significant changes in mean AVQI, intensity, dynamic range, voice tonicity, intelligibility, PROMs, and physical outcomes (manometry) were found. However, several clinically relevant changes, mostly improvements, were noted in 14 participants for AVQI and PROMs.

Conclusion

Tracheoesophageal voice, on average, is not affected by resistance-based muscle training for swallowing rehabilitation. For some participants, however, several clinically relevant improvements in voice quality and quality of life were noticeable.

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基于阻力的吞咽困难康复后气管食管发声：一项探索性多维评估。

背景：这是一项探索性研究：这项探索性研究采用多维评估方法，调查了使用SEA2.0进行为期6周的阻力性吞咽困难康复训练后气管食管的发声情况：在T0（基线）、T1（6周训练后）和T2（8周休息后）对20名喉切除者进行了评估。训练包括收下巴、张开下颌和用力吞咽。多维评估包括声学分析（AVQI、强度、动态范围）、临床医生评定的知觉评估（声音强直性、可懂性）、PROMs（VHI-10、V-RQOL、CPIB-10）以及发声时的气管测压和咽/食管高分辨率阻抗测压：结果：在平均 AVQI、强度、动态范围、声音强直性、可懂度、PROMs 和物理结果（测压）方面均未发现明显变化。然而，有 14 名参与者的 AVQI 和 PROMs 发生了一些临床相关的变化，大部分都有所改善：结论：基于阻力的吞咽康复肌肉训练平均不会影响气管食管嗓音。结论：以阻力为基础的吞咽康复肌肉训练平均不会影响气管食管嗓音，但一些参与者的嗓音质量和生活质量明显得到了一些临床相关的改善。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.