Функционална процена на прaксичката организираност на орофацијалната мускулатура кај ларингектомирани лица со аларингијална фонација

Abstract

Human communication is a complex activity that involves linguistic, cognitive and motoric skills. Speech is a set of abilities at the neurophysiological and psychological level, with one purpose, production of signals intended for the transmission of voice messages. Good, quality vocal speech in people with laryngeal phonation and people with alaryngeal phonation, implies dynamic coordination in time and space of all mechanisms that participate in the performance of speech movements and includes intensity, fluency and primarily intelligible vocal speech that is directly related to orofacial praxis. The cranial nerves have control function (V, VII, IX I XII), and the outbursts in some of them result in difficulties in the function and condition of the orofacial muscles, which are manifested by absence or difficult articulation, and in laryngectomized persons it can be manifested as impossibility or difficulty in mastering alaryngeal phonation, because the skills that are acquired are motor and sensory and involve/included the lower jaw, tongue, lips, teeth, palate, cheeks and throat. The purposeof this study is to determine whether there is a difference in the functional assessment of the state of praxis organization of the orofacial musculature between laryngectomed persons with аlaryngeal phonation and phonosurgery treated persons with laryngeal phonation and whether there is a difference in the functional assessment on the state of the praxis organization of the orofacial musculature among the laryngectomized persons with alaryngeal phonation in relation to the gender, age, type of alargingial phonation used in everyday communication. This research covered a total of 36 respondentsof which 18 laryngectomedpersons divided into three groups depending on the type of alaryngeal fonation used in everyday communication and 18 phonosurgerytreated respondents with laryngeal phonation in the control group, all rehabilitated at the University Clinic for Ear, Nose and Throat - Skopje in the period from 2011 until 2020 y. The sample includes respondents of both sexes, adults and of different ages. In this research, for data collection wereused those techniques: testing, survey and scaling. Three tests were used for functional assessment of the state of praxis organization of the orofacial muscles, which were translated into Macedonian lenguage and adapted for the purposes of this research. A Special questionnaire was developed for the needs of this research and two numerical scales were used for assessmentof the quality of the alaryngeal phonation. The laryngectomy subjects with alaringal vocal cords, on the parameters of all tests and subtests used in the study, showed significantly worse results than phonosurgery-treated subjects with laryngeal vocal cords. Miofunctional exercises (which are invaluable in vocal rehabilitation), are used during the vocal rehabilitation and in post rehabilitation process, for the respondents. However, the mutating nature of surgery and the invasiveness of HRT leaves lasting effects on the practical organization of the orofacial muscles, regardless the gender, age, and type of alaringal vocal cords used in everyday communication.