Brasnu D, Strome M, Ménard M, Pfauwadel M C, Martinez P, Janot F, Laccourreye H
Service d'Otorhinolaryngologie, Hôpital Laënnec, Université René Descartes, Paris, France.
Arch Otorhinolaryngol. 1989;246(5):407-9. doi: 10.1007/BF00463607.
An original technique of voice rehabilitation following total laryngectomy based on the concept of a myomuscosal unit was originally described by Strome. Thirty-one cases of myomucosal shunts (MMS) are analyzed in the present report. The 14 initial cases failed because of a lack clinical and surgical experience and insufficient selection of the patients. Among the last 17 cases, 1 was lost to follow-up, 1 had an insufficient follow-up, and 2 patients refused to speak with the MMS instead of a patent shunt; 5 of the remaining patients had voices evaluated as excellent, 7 had voices interpreted as good and only 1 patient had a voice evaluated as poor. Aspiration was not a problem. Eleven patients were found to stenose their shunt, but fistula were recalibrated successfully. The MMs can be used safely in oncological surgery and only 1 of 31 deaths in our total experience was due to a local recurrence. These findings show that the MMS is a reliable procedure for voice restoration following total laryngectomy; a prosthesis is not required and there are currently no oncological limits to the procedure. However, a very close follow-up of the patients is required after surgery.
一种基于肌黏膜单位概念的全喉切除术后语音康复的原创技术最初由斯特罗姆描述。本报告分析了31例肌黏膜分流术（MMS）病例。最初的14例病例失败是因为缺乏临床和手术经验以及对患者的选择不足。在最后17例病例中，1例失访，1例随访不足，2例患者拒绝使用MMS说话而选择了通畅的分流术；其余患者中有5例声音评估为优秀，7例声音解读为良好，只有1例患者声音评估为差。误吸不是问题。发现11例患者的分流术狭窄，但瘘管成功重新校准。MMS可安全用于肿瘤手术，在我们的全部经验中31例死亡中只有1例是由于局部复发。这些发现表明，MMS是全喉切除术后语音恢复的可靠方法；不需要假体，目前该手术没有肿瘤学限制。然而，术后需要对患者进行非常密切的随访。
