Timmermans A J, Krap M, Hilgers F J M, van den Brekel M W M
Uit de afdeling Hoofd-Halschirurgie van het Antoni van Leeuwenhoek Ziekenhuis in Amsterdam.
Ned Tijdschr Tandheelkd. 2012 Jul-Aug;119(7-8):357-61. doi: 10.5177/ntvt.2012.07/08.12132.
In patients with advanced laryngeal or hypopharyngeal cancer, or in cases when the disease recurs after treatment with (chemo)radiation, a total laryngectomy (TLE) is performed. For them to be able to function properly, speech rehabilitation is of the utmost importancefor these patients. For voice rehabilitation, voice prostheses or an electrolarynx can be used. Esophogus-speech can also be applied. In recent decades, voice prostheses in particular have undergone significant development. They can be considered the standard technique for rehabilitation. For dentists, it is important to realise that the anatomy of these patients has changed. In addition, many have a prior history of radiotherapy and thus an increased risk of xerostomia and osteoradionecrosis. In cases where maxillofacial surgery is indicated, the chance of osteoradionecrosis is higher. If extraction is considered, consultation with a head and neck oncology centre is necessary.
对于晚期喉癌或下咽癌患者，或在（化疗）放疗后疾病复发的情况下，需进行全喉切除术（TLE）。为使这些患者能够正常生活，言语康复对他们至关重要。对于嗓音康复，可使用嗓音假体或电子喉，也可采用食管言语。近几十年来，尤其是嗓音假体有了显著发展，可被视为康复的标准技术。对牙医而言，重要的是要认识到这些患者的解剖结构已发生变化。此外，许多患者有放疗史，因此口干和放射性骨坏死的风险增加。在需要进行颌面外科手术的情况下，发生放射性骨坏死的几率更高。如果考虑拔牙，有必要咨询头颈肿瘤中心。
