Brasnu D, Strome M, Ménard M, Janot F, Fabre A, Laccourreye H
Service d'Oto-Rhino-Laryngologie, Hôpital Laënnec, Paris.
Ann Otolaryngol Chir Cervicofac. 1988;105(6):449-52.
Twenty seven cases of Myomucosal Tracheoesophageal shunt following total laryngectomy performed at Laennec Hospital are presented. The surgical technique which was initially reported by M. Strome is summarized. The advantages of this procedure as compared to other tracheoesophageal fistulas are discussed. The first sixteen cases of this series failed: 12 stenoses occurred and 4 flaps necrosed. The eleven last Myomucosal shunts of this series are functioning. Aspiration was only problematic in one case. Six of the eleven functioning shunts have excellent voicing; three other patients are able to voice before completion of speech therapy and one patient has a too short follow-up for voice evaluation. The authors emphasize the contra-indications for the procedure. Medical conditions that can potentially lead to flap necrosis include: arteritis, diabetes mellitus, and gastrointestinal reflux.
本文介绍了在拉埃内克医院进行的27例全喉切除术后肌黏膜气管食管分流术的病例。总结了最初由M. 斯特罗姆报道的手术技术。讨论了该手术与其他气管食管瘘相比的优势。该系列的前16例手术失败：发生了12例狭窄，4例皮瓣坏死。该系列最后11例肌黏膜分流术功能良好。仅1例存在误吸问题。11例功能良好的分流术中，6例发音效果极佳；另外3例患者在言语治疗完成前就能发声，1例患者随访时间过短，无法进行语音评估。作者强调了该手术的禁忌证。可能导致皮瓣坏死的医学状况包括：动脉炎、糖尿病和胃食管反流。
