Wu Yanqiao, Shang Yaodong, Zhou Yongqing, Tao Zhen feng, Li Qi, Di Bin, Xiao Shu fen, Song Qi, Zhao Guoqing
Department of Otolaryngology, Bethune International Peace Hospital, Shijiazhuang 050082.
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2002 Sep;16(9):462-4.
The purpose of this study is to discuss long-term results of one different kind of voice restoration after total laryngectomy with 10 years experience.
One stage tracheoesophageal end-side anastomosis after total laryngectomy was performed in 36 patients from 1991-1996. The key technique of this operation is to make a tongue-ship flap(1.5 cm x 1.5 cm-1.8 cm x 1.5 cm) with tracheal membranous part and dissect it from the esophagus to 1 cm below the upper incisal margin of trachea. Then a 0.8 cm middle vertical incision was made on the lowest anterior wall of the separated esophagus. Folding the tongue-ship flap posteriorly to approximate the esophagus incision and make an end-side anastomosis. Close the upper incisal margin of trachea with left to right direction suture. The follow up time is 5 - 10 year. One lost follow 2.5 years later and was judged as dead.
The short-term and long-term success rate were 69% (25/36) and 83% (30/36) respectively. The 3-, 5- and 10 year survival rate are 72%, 69%, 69%, respectively.
This technique does not change the pattern of total laryngectomy and various neck dissections do not affect voice rehabilitation. Advantages of the operation: easy to operate and learn; the special form of tracheoesophageal shunt (high in the tracheal side and low in esophageal side) prevents the aspiration; high successful rate, excellent speech, fluent language, good acceptability and lower aspiration.
