背景:全喉切除术后,手术语音恢复被认为是通过气管食管语音重建通信的最佳方式。然而,除了插入语音假体以引起语音产生之外,在如何恢复气管食管语音的感知质量方面,临床知识并不理想。本系统评价将确定并严格评估气管食管语音治疗干预的质量和有效性。这篇综述的发现将为新型气管食管语音治疗干预的发展提供信息。
方法:根据PRISMA指南进行系统文献综述。
方法:审查方案在PROSPERO注册。使用预定的搜索策略搜索了八个电子数据库。记录由两名审查人员根据纳入和排除标准进行独立筛选。使用PEDro评估合格研究的质量,Robin-T,和NHLBI关键评估工具。提取了与参与者特征和内容有关的数据,剂量,干预的强度和结果。
结果:确定了6344条记录,其中38项被纳入全文审查。六项研究符合纳入资格标准。语音康复不是大多数研究的主要重点,并且在所有研究中都确定了偏倚的风险。研究中使用的干预措施和结果指标存在显着的异质性,关于气管食管语音的干预内容提供的细节不足。干预措施有效性的证据是有限的,并且在各研究中不一致。
结论:这篇综述发现,气管食管嗓音治疗是临床实践中一个研究不足的领域。目前,来自现有研究的少量证据不足以为临床实践提供信息。这篇综述强调了开发和测试旨在改善气管食管语音感知质量的干预措施的必要性。
BACKGROUND: Following total laryngectomy, surgical voice restoration is considered the optimal modality for re-establishing communication via
tracheoesophageal voice. Yet beyond the insertion of a voice prosthesis to elicit voice production, there is suboptimal clinical knowledge of how to rehabilitate the perceptual quality of
tracheoesophageal voice. This systematic review will identify and critically evaluate the quality and effectiveness of therapeutic interventions for
tracheoesophageal voice. The findings of this review will inform the development of a novel
tracheoesophageal voice therapy intervention.
METHODS: Systematic literature review carried out in accordance with PRISMA guidelines.
METHODS: The review protocol was registered with PROSPERO. Eight electronic databases were searched using a prespecified search strategy. Records were independently screened by two reviewers against inclusion and exclusion criteria. Eligible studies were assessed for quality using the PEDro, ROBIN-T, and NHLBI critical appraisal tools. Data was extracted pertaining to participant characteristics and the content, dosage, intensity and outcomes of interventions.
RESULTS: 6344 records were identified, of which 38 were included for full-text review. Six studies met the eligibility criteria for inclusion. Voice rehabilitation was not the primary focus in the majority of studies, and the risk of bias was identified across studies. There was significant heterogeneity in the interventions and outcome measures used within studies with insufficient detail provided on intervention content for tracheoesophageal voice. Evidence for the effectiveness of interventions was limited and inconsistent across studies.
CONCLUSIONS: This review found that
tracheoesophageal voice therapy is an under-researched area of clinical practice. Evidence from the small body of existing studies was not sufficiently robust to inform clinical practice at this time. This review highlights the necessity to develop and test interventions aimed at improving the perceptual quality of tracheoesophageal voice.