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At least 667 records · Page 37Linked to original sources
PubMed2005

[Retrospective analysis of tracheoesophageal shunt for voice reconstruction after total laryngectomy].

OBJECTIVE: To review the effect of tracheoesophageal shunt on voice reconstruction after total laryngectomy and prevention from deglutition disorders. METHOD: Twenty-seven patients with laryngeal cancer were conducted an operation of tracheoesophageal shunt after total laryngectomy. The vertical voiced slit with a length of 1.0-1.5 cm was made between the posterior wall of trachea and frontal wall of esophagus, while the new epiglottis was made above tracheoesophageal shunt to prevent from deglutition disorders. RESULT: In this series, 23 of 27 patients kept good voice function, the successful rate was 85.2%. 22 of 23 patients avoided deglutition disorders, but 1 of 23 failed to do so. The 3-year and 5-year survival rate were 66.7% (18/27) and 48.1% (13/27), respectively. CONCLUSION: The operation of tracheoesophageal shunt is advantageous to restore the voice function and prevent deglutition disorders.

Aged↗
PubMed2005

[Analysis of pharyngeal phase of swallowing after supracricoid partial laryngectomy with cricohyopexia (CHP) and cricohyoepiglottopexia (CHEP)].

The analysis of efficiency and timing of pharyngeal phase events after supracricoid reconstructive laryngectomy was presented. Material consist of 15 patients after partial laryngectomy with cricohyopexia (CHP) and 19 with cricohyoepiglottopexia (CHEP) in average age of 53 (41-66) years. The video-radiographic examination of swallowing was done in the early period (max. 120, average 72 days) and in the late period (min. 10, average 24 months) after surgery. The larynx closure improved and the wide of upper oesophageal sphincter (UES) increased in the late period comparing to first examination. The duration of UES relaxation and the duration of pharyngeal phase were similar to physiological status but the time of larynx closure was longer in both periods.

Adult↗
PubMed2005

[Prognostic value of low hemoglobin concentration in adjuvant radiotherapy after total laryngectomy in group of patients with laryngeal cancer].

PURPOSE: To investigate the impact of hemoglobin concentration (Hb) at the start and end of radiotherapy, and the drop of hemoglobin concentration during radiotherapy on the loco-regional control in postoperative radiotherapy for patients with advanced laryngeal cancer. MATERIALS AND METHODS: Between January 1993 and December 1996, 254 patients with pT3 or pT4 and pN0-pN2 laryngeal cancer were treated with a total laryngectomy and adjuvant radiotherapy (RT). The median age of patients was 56.3 years (range: 30-70 years). The analyzed group consisted of 236 males (92%) and 18 females (8%). In all cases a total laryngectomy was performed. 196 out of 254 patients underwent homolateral neck dissection and 58 out of 254 underwent bilateral neck dissection. The primary tumor bed was irradiated to the median total dose of 61.2 Gy (range: 57 - 64 Gy) and all regional lymph nodes were treated in all patients to a dose of 50 Gy. Indications for postoperative RT were close postoperative margins at the tumor site or pathological status of lymph nodes described as pN1 or pN2. Univariate analyses were used to determine the predictors for locoregional failure. The following factors were studied for prognostic importance of loco-regional outcome: the hemoglobim concentration at the start of radiotherapy, at the end of radiotherapy, and the drop of hemoglobin concentration during radiotherapy, age, sex, pT and pN categories. RESULTS: The actuarial 5-year overall survival was 49%, the actuarial loco-regional control rate was 70%. Univariate analysis, using log-rank test indicated that pN +, Hb level at the end of RT (p = 0.004) and drop during RT (p = 0.038) were predicted for the loco-regional control of postoperative radiotherapy. CONCLUSIONS: Analysis showed that the low level of Hb at the end of radiotherapy and the drop during radiotherapy were correlated with decreasing of the loco-regional control of adjuvant radiotherapy for patients with advanced laryngeal cancer.

Adult↗
PubMed2005

[Complications of tracheoesophageal puncture for Blom-Singer voice restoration after total laryngectomy].

OBJECTIVE: To investigate causes and treatment of complications of tracheoesophageal puncture for Blom-Singer voice restoration after total laryngectomy. METHODS: From 1986 to 2004, one hundred and fifty one cases with Blom-Singer technique after total laryngectomy for voice restoration were retrospectively analyzed. RESULTS: All cases were followed up from 6 months to 15 years. Among 151 cases, 138 cases got successful phonation and the total success rate of voice restoration was 91.4%. Of the 151 cases, 15 cases occurred complications. The rate of complications was 9.9%. The common complications included fistula granulations, infection, and leakage. Twelve cases got successful treatment accordingly, and the other 3 cases failed in phonation. CONCLUSIONS: The procedure of tracheoesophageal puncture for voice restoration is relatively simple and has low complications. this method had high phonation success and good phonation quality, which is one of the best way to make laryngectomee to speak.

Adult↗
PubMed2006

[Analysis of mono-side sternohyoid myo-osteal flap used in reconstruction after partial laryngectomy].

OBJECTIVE: To evaluate the reconstruction effect and to investigate applied indication of unilateral sternohyoid muscle flap with hyoid bone in laryngeal carcinoma after partial laryngectomy. METHOD: Seventy-three identified cases have been analysed by retrospective process. Statistic data mainly include postoperative eating condition, decannulation rate and postoperative voice. Detailed data of decannulation rate have been contrasted in different clinical stages, clinical types and operation types of malignant tumor. More data include three year, postoperative complications and so on. RESULT: There are about 79.5% cases survived three years or more. All the cases can take food by mouth without gastric tube after the operation, 12.9 days in average. The total decannulation rate is 76.7% and difference is found between enlarged-vertical hemilaryngectomy and the other types of operations. More than 83.6% patients can speak in a nearly normal way. CONCLUSION: The decannulation rate, voice and swallowing function are all recovered satisfactory after the reconstruction and the decannulation rate is not influenced by clinical stage or else of laryngeal carcinoma, but only by the range of ectomy. The mono-side sternohyoid muscle flap with hyoid bone can restore a baggish defect of larynx, and the survival rate is satisfied. It can take the place of full laryngectomy in some T3 or T4 cases whose extent of disease laid particular emphasis on one side.

Adult↗
PubMed2006

[Vocal sound study in supracricoid partial laryngectomy].

OBJECTIVE: Vocal sound was studied in 21 patients underwent supracricoid partial laryngectomy using Dr. Speech. METHOD: Vocal sound tests and frequency spectrum analysis were used in 4 different approaches (CHEP, CHP, TCHEP, TCHP) both before and after the operation. RESULT: Vibration pattern of new glottidis formed after the four different operation approaches was approximately the same demonstrating an augmentation of mucous membrane fluctuation. This vibration pattern were increasing and stabilizing gradually with time. CONCLUSION: Retaining on both sides and one side in supracricoid partial laryngectomy facilitates restoration of vocal function.

Aged↗
PubMed1991

[Subtotal laryngectomy in the treatment of extensive tumors of the larynx].

The authors assess the possibility to perform subtotal laryngectomy for extensive tumors of the endolarynx. They describe a particular variety of T3/T4 tumor extending anteriorly to the thyroid cartilage or to the pre-epiglottic space. Such tumors do not affect the arytenoid cartilages posteriorly, which makes functional subtotal laryngectomy with CHP or CHEP possible. This surgery was performed in 28 patients from 1972 to 1985, with 20 patients still living after 5 years, ie. 72% of all cases.

Humans↗
PubMed1991

[Local approaches to extensions of laryngeal cancers: implications for anatomo-pathological testing of surgically removed specimens after laryngectomy].

The pathological examination of partial or total laryngectomy specimens for primary laryngeal cancer presents some difficulties that are related to the complex anatomical configuration of this organ. Moreover, the local spread is depending on the primary location of the lesion. The pathological findings are of special importance because they are used for planning postoperative treatment and for predicting prognosis. The gross study is the most important time but it needs to be completed by histopathological study on whole organ serial sections or on selected parts. This last event is often the only appropriate one for routine examination but it needs to know as well as possible the usual modes of invasion in accordance to the primary location. This work presents the results of the pathological topographic study in 251 partial or total laryngectomy specimens that were removed because of primary laryngeal cancer.

Humans↗
PubMed1991

[Radiologic findings following supraglottic and total laryngectomy].

The treatment of carcinoma of the larynx has recently been greatly improved with the development of supraglottic and total laryngectomy. This has also led to a high five year survival rate. The normal postoperative radiological appearances are presented together with the spectrum of relevant radiological investigations and their indications. The most frequently seen postoperative complications and findings in patients with dysphagia are described with special reference to pharyngograms and cineradiography. The morphology of the vibrating segment after laryngectomy in patients who do not develop effective alaryngeal speech is demonstrated.

Cineradiography↗
PubMed1991

[Objective study of the voice quality following partial laryngectomy].

The high resolution frequency analyzer is used for the study of the vocal quality after partial laryngectomy. The post-operative plot after speech therapy is of good quality when respecting one vocal fold. On the contrary, the heard vocal sound does not correspond to the harmonics of the fundamental frequency but to intense noise from irregular vibrations of the residual laryngeal mucosa (ventricular folds, arytenoids). High resolution frequency analysis contributes to the follow-up of the partial laryngectomy.

Glossectomy↗
PubMed1990

[Laryngectomy with Tucker's epiglottoplasty].

From 1980 to 1987, 37 patients were operated with a reconstructive anterior frontal laryngectomy including epiglottoplasty such as described by Tucker. These patients presented with epidermoid carcinomas of the glottis. The carcinological results are satisfactory, with a survival rate of 33 of 37 patients at 3 years and 22 of 25 patients at 5 years. However, the control of the paraglottic space still is insufficient after this type of surgery, and we reserve it for the tumors confined to the glottic level, without impairment of mobility. The anterior frontal laryngectomy performed is extensive and frontolateral. It is used for a few of its former indications, as showed by the comparison of the periods before and after 1980.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

[Partial vertical laryngectomies: reconstruction with a platysma myocutaneous flap].

Partial vertical laryngectomies have been performed successfully for nearly one century. Hemilaryngectomies may present more evidence of difficulties and complications and both can be controlled with reconstructive methods. Thus, the authors present 6 patients with T1 and T2 glottic tumors submitted to hemilaryngectomy (5 cases) and to frontolateral laryngectomy (1 case) reconstructed with platysma myocutaneous flap. The oncologic and functional results were analyzed for follow-up from 2 to 5 years. Observation was made of time for decanulization, start of swallowing, presence of oro-tracheal. aspiration, vocal quality (roughness, breathiness, and inteligillity), physical activity, and complications. The authors conclude that such a method does not affect oncologic results and represents an adequate support to the organ, facilitating amplified resections.

Adult↗
PubMed1990

[Patients excluded from voice restoration after total laryngectomy].

Concerning 73 radical laryngectomy operations carried out at the Hôpital Tenon in the period between july 1985 and july 1989, the authors studied the mode of vocal restoration used and the patient population not benefitting from any of the procedures used. Esophageal voice was utilized initially in 19 patients; a tracheo-esophageal fistula (surgical shunt or puncture with Blom-Singer prosthesis) was created during laryngectomy in 19 patients, and secondary tracheo-esophageal puncture was performed in 13 others. Twenty patients had no vocal restoration operation performed. In a large number of the patients, the tracheo-esophageal fistulas restored a normal voice. In the end, 38% of the laryngectomized patients did not have their voice restored. The various causes for such a high percentage of exclusions that are discernable are discussed. Lack for motivation on the part of the patients is a major reason, irrespective of the technique used.

Adult↗
PubMed1989

[Epiglottic reconstruction after near total laryngectomy].

Near total laryngectomy results in large defect of the larynx requiring reconstruction. Pedicled composite epiglottic flap containing cartilage and epithelium is an ideal reconstructive tissue. This paper describes our experiences with 15 cases who underwent epiglottic laryngoplasty after near total laryngectomy since 1983. In order to avoid too wide a glottis leading to aspiration and poor voice, the Tucker technique has been modified in two ways: (1) The posterior edge of the epiglottis was sutured separately to the posterior edge of the cricoid opposing the true and false cords rather than the thyroid alar struts; An arytenoid was reformed. (2) Bilateral edge of the epiglottis was lowered. Anew pseudocord was formed. (3) The anterior epiglottic flap was manipulated to simulate the shape of anterior commissure. These modified reconstructive techniques resulted in decreasing in the transverse diameter and increasing slightly in the anterior-posterior length of the glottis, the functions of deglutition, phonation and respiration were improved significantly None had developed local recurrence and distant metastasis in more than 2-4 years.

Aged↗
PubMed1989

[Prosthetic vocal rehabilitation of Herrmann's type after total laryngectomy. Results apropos of 29 cases].

The authors performed 29 surgical interventions of this type (24 primary and 5 secondary implantations). The treatment protocols, especially, the radio-chemotherapeutic protocols, were not changed and the radiotherapeutic tolerance of these prosthetic implants was particularly outstanding. This method may find wide application as well after single total laryngectomy as after circular total pharyngeal laryngectomy with restoration by gastric transplant. Speech is generally produced as early as the 12th day and we may assert that it is much better than esophageal speech, the whole indications and results being considered. These are being discussed and sustained support by the therapeutic team appears to be necessary.

Humans↗
PubMed1989

[Rehabilitation in esophageal speech and its perceptive-acoustic features after total laryngectomy without pharyngo-esophageal plastic surgery].

The experiences with the plastic surgery of pharyngo-oesophageal sphincter during the laryngectomy were presented. The sphincteric forces were studied accordingly to the rehabilitation successes and also the acoustic and perceptive data of the oesophageal speech. The results were compared with these after the classical laryngestomy. It was pointed out that the sphincteroplasty lowered its tension and made the rehabilitation more easier. The oesophageal voice produced in this occasion is better than after the classical laryngectomy. The fundamental frequency is two times higher, the prosody and speech tempo more normal. These positive results were encountered in 76% of cases. However, in some cases the psychological and social difficulties were so great that we preferred the surgical rehabilitation with shunt formation.

Adult↗
PubMed1989

[The psychological and social condition of patients after total laryngectomy].

The paper reports on a group of 55 patients after total laryngectomy performed on average 6.5 years ago. Their average age was 62 years. The patients were given a questionnaire and answered 103 questions related to their psychic and social situation after the surgery, which necessitated the use of permanent endotracheal cannula. The patients' most common complaints were speech defects, then a feeling of insufficient air, or "being short of breath", loss of physical fitness, and limited job opportunities. Comprehensive rehabilitation starts well before surgery. Assistance of the family and friends is also considered important, especially during oesophageal speech. The authors recommend to take more advantage of comprehensive spa rehabilitation for patients with total laryngectomy.

Adult↗
PubMed1989

[Comparative studies of the quality of the esophageal voice following laryngectomy: the insufflation test and reverse speech audiometry].

We carried out a transnasal insufflation test according to Blom and Singer on 27 laryngectomy patients as well as a speech communications test with the help of reverse speech audiometry, i.e. the post laryngectomy telephone test according to Zenner and Pfrang. The combined evaluation of both tests provided basic information on the quality of the esophagus voice and functionability of the speech organs. Both tests can be carried out quickly and easily and allow a differentiated statement to be made on the application possibilities of a esophagus voice, electronic speech aids and voice prothesis. Three groups could be identified from our results: 1. Insufflation test and reverse speech test provided conformable good or very good results. The esophagus voice was well understood. 2. Complete failure in the insufflation and telephone tests calls for further examinations to exclude any spasm, stricture, divertical and scarred membrane stenosis as well as tumor relapse in the region of the pharyngo-esophageal segments. 3. Organic causes must be looked for in the area of the nozzle as well as cranial nerve failure and social-determined causes in the case of normal insufflation and considerably reduced speech communication in the telephone test.

Adult↗