Revision surgery of a stenotic speaking shunt in near-total laryngectomy patients

Chih Ying Su*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

3 Scopus citations

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 languageEnglish
Pages (from-to)619-622
Number of pages4
JournalAnnals of Otology, Rhinology and Laryngology
Volume107
Issue number7
DOIs
StatePublished - 1998
Externally publishedYes

Keywords

  • Hypopharynx
  • Larynx
  • Near-total laryngectomy
  • Neoplasm
  • Revision
  • Speaking shunt stenosis

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