Mechanism of Vowel Phonation in T-E Shunt Patient using MR Imaging after Total Laryngectomy

후두 전적출술후 MR영상을 이용한 음성재활환자의 발성기전에 관한 연구

Total laryngectomy has become an usual treatment for any advanced carcinoma of the laynx, but most patients who have undergone total laryngectomy have shown permanant disability in voice production. I compared the first three formant frequencies estimated from MRI to those measured directly from speech data of the T-E patients and the normal. It was to estimate the accuracy of MRI and to compare the vocal tract shape of the normal to T-E patients. The obtained results were as follows : 1. The middle sagittle section of the MRI represents vocal tract well during pnonation. The vocal tract shape of the T-E shunt patients are lack of pharyngeal space and superior space of the glottis. 2. The length of the normal subject's vocal tract is 17 cm. For the T-E shunt patients, the length from lip to shunt opening is 17.5 cm in case 1, and 18.5 cm in case 2. That of the true resonante chamber is 13 cm and 13.5 cm for each case respectively. 3. T-E shunt patients phonated strained voice. The intensity of the higher formant frequency decreased especially in /o/, /u/. 4. The vocal tract is shortened during the phonation by T-E shunt patients. In case of /e/ and /i/, front cavities are constricted while back cavities are shortened. 5. The pseudoglottis of the T-E shunt patients is located at $14{\sim}15\;cm$ below from lips.