Chone Carlos Takahiro, Spina Ana L, Crespo Agricio N, Gripp Flavio M
Faculdade de Ciências Médicas, Universidade Estadual de Campinas.
Braz J Otorhinolaryngol. 2005 Jul-Aug;71(4):504-9. doi: 10.1016/s1808-8694(15)31207-6. Epub 2005 Dec 15.
To evaluate long-term use of indwelling Blom-Singer voice prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). We studied the influence of time of performance of tracheo-esophageal puncture (TEP), use of radiotherapy (XRT), patients' age and length of follow-up, on the rate of success of use of VP.
Clinical prospective.
Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. Both otolaryngologist and speech pathologist evaluated all patients for the vocal functional issues during the follow-up. The relative data on time of placement of VP, time of use of PF, use of XRT, age, length of follow-up and interval of duration of each VP were recorded during the follow-up.
There was 87% of patients with primary TEP and 13% with secondary. The follow-up varied from 12 to 87 months, with average of 38 months for primary and 51 months for secondary TEP. There were 59% of patients submitted to XRT. The general rate of success was of 94%. In primary TEP it was of 97% and in the secondary, it was 78% (p=0.07) and after two years, the success rate was of 96% in primary TEP and 75% in secondary TEP (p=0.07). The use of XRT and patient age did not influence the success of use of VP among primary and secondary TEP, independently of length of follow-up.
Tendency to greater success rate in voice rehabilitation after TL with primary TEP was observed. Postoperative XRT and age did not influence success rate.
为评估长期使用留置型Blom-Singer语音假体(VP)对全喉切除术(TL)患者进行嗓音康复的效果。我们研究了气管食管穿刺(TEP)时间、放疗(XRT)的使用、患者年龄和随访时间对VP使用成功率的影响。
临床前瞻性研究。
71例患者接受了TL手术并使用留置型VP进行康复。在随访期间,耳鼻喉科医生和言语病理学家对所有患者的嗓音功能问题进行评估。随访期间记录了VP置入时间、PF使用时间、XRT使用情况、年龄、随访时间以及每个VP的使用持续时间间隔等相关数据。
原发性TEP患者占87%,继发性患者占13%。随访时间从12个月到87个月不等,原发性TEP平均为38个月,继发性TEP平均为51个月。59%的患者接受了XRT。总体成功率为94%。原发性TEP的成功率为97%,继发性为78%(p = 0.07),两年后,原发性TEP的成功率为96%,继发性TEP为75%(p = 0.07)。无论随访时间长短,XRT的使用和患者年龄均不影响原发性和继发性TEP中VP使用的成功率。
观察到原发性TEP术后嗓音康复成功率有更高的趋势。术后XRT和年龄不影响成功率。