Voice restoration by primary insertion of indwelling voice prosthesis following circumferential pharyngolaryngectomy with free jejunal graft

Auris Nasus Larynx. 2005 Sep;32(3):269-74. doi: 10.1016/j.anl.2005.03.009.

Abstract

Background: Voice restoration after circumferential pharyngolaryngectomy (CPL) with free jejunal graft remains a difficult problem to solve. Few reports have analyzed the success rate and complications following primary insertion of indwelling voice prostheses during CPL with free jejunal graft.

Patients and methods: Eight patients who underwent CPL with free jejunal graft had a Groningen voice prosthesis inserted as a tracheoesophageal (TE) shunt at the time of oncological surgery. A 10-point scale was used to assess each patient's speech intelligibility. Complications following the voice prosthesis insertion were also analyzed.

Results: Six of the eight patients (75%) achieved excellent speech intelligibility and the remaining two patients (25%) were judged as moderate. Six of the eight patients (75%) used the TE shunt as their major means of daily communication. Leakage through or around the prosthesis, which occurred in six (75%) patients, was the most frequent prosthesis-related complication.

Conclusions: This safe and reliable technique can be effective in improving the quality of life in selected patients undergoing CPL.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Hypopharyngeal Neoplasms / surgery
  • Jejunum / transplantation*
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / rehabilitation*
  • Larynx, Artificial*
  • Male
  • Middle Aged
  • Pharyngectomy / rehabilitation*
  • Prosthesis Design
  • Speech Intelligibility*
  • Speech, Alaryngeal
  • Treatment Outcome