ISSN:
1434-4726
Keywords:
Total laryngectomy
;
Myomucosal shunt
;
Tracheoesophageal fistula
;
Voice rehabilitation
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary An original technique of voice rehabilitation following total laryngectomy based on the concept of a myomucosal unit was originally described by Strome. Thirty-one cases of myomucosal shunts (MMS) are analyzed in the present report. The 14 initial cases failed because of a lack clinical and surgical experience and insufficient selection of the patients. Among the last 17 cases, 1 was lost to follow-up, 1 had an insufficient follow-up, and 2 patients refused to speak with the MMS instead of a patent shunt; 5 of the remaining patients had voices evaluated as excellent, 7 had voices interpreted as good and only 1 patient had a voice evaluated as poor. Aspiration was not a problem. Eleven patients were found to stenose their shunt, but fistula were recalibrated successfully. The MMs can be used safely in oncological surgery and only 1 of 31 deaths in our total experience was due to a local recurrence. These findings show that the MMS is a reliable procedure for voice restoration following total laryngectomy; a prosthesis is not required and there are currently no oncological limits to the procedure. However, a very close follow-up of the patients is required after surgery.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00463607
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