Abstract
A near-total operation to create a speaking shunt is generally considered a suitable option in most T3 laryngopharyngeal cancer cases. However, some of these cases incur postoperative problems, including aspiration and shunt stenosis. In this 8-year study, 15 of 60 patients who had received near-total laryngectomies could not speak well with their shunts. Revision surgery was performed on 11. Under local anesthesia, the lumen of the stenotic segment of the shunt was opened. A 4-F silicone tube was stented in the shunt. Then, for mildly stenotic cases, the small mucosal defect of the shunt was covered by a sternohyoid myofascial flap. For moderate to severe cases, the larger mucosal defect was reconstructed with a free skin graft. Thereafter, a sternohyoid muscle flap was used to cover the skin graft, which would finally form the inner lining of the new speaking shunt. The outcome was that 9 of the 11 patients acquired intelligible shunt speech. These results demonstrate that the augmentation procedures described herein have considerable potential for restoring the function of a stenotic speaking shunt in a near-total laryngectomee.
Original language | English |
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Pages (from-to) | 619-622 |
Number of pages | 4 |
Journal | Annals of Otology, Rhinology and Laryngology |
Volume | 107 |
Issue number | 7 |
DOIs | |
State | Published - 1998 |
Externally published | Yes |
Keywords
- Hypopharynx
- Larynx
- Near-total laryngectomy
- Neoplasm
- Revision
- Speaking shunt stenosis