Damrose Edward J
Division of Laryngology, Department of Otolaryngology/Head and Neck Surgery, Stanford University Medical Center, 801 Welch Road, Stanford, CA, 94305, USA.
Eur Arch Otorhinolaryngol. 2009 May;266(5):759-61. doi: 10.1007/s00405-008-0713-x. Epub 2008 May 28.
Near-total laryngectomy is a surgical technique which grants the potential for postoperative speech without the need for prostheses or secondary surgical procedures. Aspiration can be a problem, however, that can require completion laryngectomy to resolve. A 60-year-old male underwent a near-total laryngectomy for recurrent laryngeal cancer. The patient developed chronic aspiration secondary to a leaking shunt. Work up was negative for recurrent cancer. Calcium hydroxylapatite was injected transorally at the opening into the shunt and transtomally into the exit of the shunt to seal it. Postoperative barium swallow showed resolution of aspiration. At approximately 17 months, the patient developed recurrent intermittent aspiration of thin liquids and required reinjection of the shunt, with resolution of the aspiration. Calcium hydroxylapatite allows simple and effective alleviation of aspiration following near-total laryngectomy but requires repeated injection to maintain efficacy. Injection of calcium hydroxylapatite can be an effective alternative to completion laryngectomy in patients who aspirate following near-total laryngectomy.
近全喉切除术是一种手术技术，它使患者术后无需假体或二次手术即可实现发声。然而，误吸可能是一个问题，可能需要进行全喉切除术来解决。一名60岁男性因复发性喉癌接受了近全喉切除术。患者因分流管渗漏继发慢性误吸。复查未发现复发性癌症。经口在分流管开口处及经皮在分流管出口处注射羟基磷灰石以封闭分流管。术后钡剂吞咽造影显示误吸得到解决。大约17个月时，患者出现稀薄液体反复间歇性误吸，需要再次注射封堵分流管，误吸得以解决。羟基磷灰石可简单有效地缓解近全喉切除术后的误吸，但需要重复注射以维持疗效。对于近全喉切除术后出现误吸的患者，注射羟基磷灰石可以作为全喉切除术的一种有效替代方法。
