Krishnan Suren, Maclean Julia
Department of Surgery, University of Adelaide, and Department of Otolaryngology, Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, South Australia.
Curr Opin Otolaryngol Head Neck Surg. 2013 Jun;21(3):224-9. doi: 10.1097/MOO.0b013e32836118aa.
To provide a perspective of contemporary practice in rehabilitation of speech and swallowing in patients undergoing total laryngectomy in Australia.
In Australia, the preferred method of voice rehabilitation is by the use of tracheo-oesophageal voice prosthesis. Dysphagia is an ongoing problem and the use of adjuvant radiation and chemotherapy compounds this problem. There are difficulties associated with surgery because of the variation in disease involvement of pharyngeal mucosa and musculature, as well as difficulties associated with healing in previously chemoradiated surgical fields.
This article demonstrates the need for careful consideration of surgical technique, particularly in closure of the neopharynx in the chemoradiated patient. It encourages further research into the problems of speech and particularly swallowing in this patient population, as these problems impact significantly on the quality of life.
提供澳大利亚全喉切除患者言语和吞咽康复当代实践的观点。
在澳大利亚，语音康复的首选方法是使用气管食管语音假体。吞咽困难是一个持续存在的问题，辅助放疗和化疗会使这个问题更加复杂。由于咽黏膜和肌肉组织疾病累及情况的差异，手术存在困难，并且在先前接受过放化疗的手术区域愈合也存在困难。
本文表明需要仔细考虑手术技术，特别是在接受过放化疗患者的新咽部闭合方面。它鼓励对该患者群体的言语问题，尤其是吞咽问题进行进一步研究，因为这些问题对生活质量有重大影响。
