Mehta A R, Sarkar S, Mehta S A, Bachher G K
Department of Surgical Oncology, Tata Memorial Hospital, Parel, Bombay, India.
Eur Arch Otorhinolaryngol. 1995;252(4):209-14. doi: 10.1007/BF00179913.
A 3-year prospective study on primary tracheoesophageal puncture was carried out at Nanavati Hospital and Tata Memorial Hospital, Bombay, to assess its feasibility in a developing country and its success in vocal rehabilitation. We report our experience with primary tracheoesophageal puncture in 64 patients (57 males and 7 females) following surgical treatment for carcinoma of the pyriform fossa (45 cases) and endolarynx (19 cases). All patients underwent total laryngectomies with or without partial pharyngectomy and primary pharyngeal mucosal closure. Fifty-one patients underwent primary surgery followed by postoperative radiotherapy. At 3 months successful tracheoesophageal speech was achieved in 84% patients, although this percentage decreased to 67% at 9 months. There were no major complications. Successful vocal rehabilitation was related more to "patient factors" such as delays in seeking medical attention when prosthetic valves dislodged, improper use and care of the valves and inability to learn speech with the prosthesis. Overall, primary tracheoesophageal puncture was found to be feasible and should be used more extensively for vocal rehabilitation following laryngectomy in developing countries.
在孟买的纳纳瓦蒂医院和塔塔纪念医院开展了一项关于一期气管食管穿刺的为期3年的前瞻性研究，以评估其在发展中国家的可行性及其在嗓音康复方面的成功率。我们报告了64例患者（57例男性和7例女性）一期气管食管穿刺的经验，这些患者均接受了梨状窝癌（45例）和喉内癌（19例）的手术治疗。所有患者均接受了全喉切除术，部分患者还接受了部分咽切除术及一期咽黏膜封闭术。51例患者接受了一期手术，术后接受放疗。3个月时，84%的患者实现了成功的气管食管发音，但9个月时这一比例降至67%。未发生重大并发症。成功的嗓音康复更多地与“患者因素”有关，如人工瓣膜移位时就医延迟、瓣膜使用和护理不当以及无法使用假体学习发音。总体而言，一期气管食管穿刺被认为是可行的，在发展中国家应更广泛地用于喉切除术后的嗓音康复。
