Strome M, Mustoe T A, Kelly J H
Arch Otolaryngol Head Neck Surg. 1986 Nov;112(11):1168-71. doi: 10.1001/archotol.1986.03780110044005.
Surgical procedures for speech rehabilitation following laryngectomy lack wide support owing to tumor recurrence, aspiration, stenosis of the fistula, and multiple surgical stages of limited usefulness in irradiated patients. The recent prostheses and their modifications have approximately a 70% success rate but similarly remain limited by the requisite maintenance and soilage. A mucosa-lined tracheoesophageal fistula with a functioning proximal muscle sphincter, created in one stage at laryngectomy, is described. This myomucosal unit can function with or without a prosthesis and potentially eliminates aspiration. Evolution of the flap design in an animal model is delineated and the clinical trial in six patients high-lighted. Five of the six have an excellent vocal quality without an associated air leak on phonation. Three function without a prosthesis.
喉切除术后语音康复的外科手术因肿瘤复发、误吸、瘘管狭窄以及在接受放疗的患者中多个手术阶段效果有限而缺乏广泛支持。近期的假体及其改良方法成功率约为70%，但同样受到必要维护和污染问题的限制。本文描述了一种在喉切除术中一期创建的、带有功能性近端肌肉括约肌的黏膜内衬气管食管瘘。这个肌黏膜单元无论有无假体都能发挥功能，并有可能消除误吸。阐述了动物模型中皮瓣设计的演变，并重点介绍了对6例患者的临床试验。6例患者中有5例嗓音质量极佳，发声时无相关漏气。3例无需假体即可发挥功能。
