Videoradiography of free jejunal grafts for rehabilitation of speech in laryngectomized patients.
In laryngectomized patients a tracheo-esophageal artificial fistula can be used to achieve air flow from the trachea to the esophagus during speech. A one-way plastic valve is often used for the fistula. A free jejunal graft between the trachea and the esophagus can also be used. To avoid aspiration the transplant is attached to the submental area giving the graft a siphon-like shape. We performed 23 videoradiographic examinations using high-density barium in 14 such patients. The aim was to evaluate the protective function of these grafts against aspiration. Penetration of the bolus and a small amount of residual contrast material in the ascending limb of the graft was a normal finding. If the standard barium bolus reached the descending limb at any time during the examination, this was a sign of aspiration hazard. To avoid aspiration, the vertex of the speech siphon should be higher than the level of the hypopharyngeal anastomosis.
Pokieser
P
P
Department of Radiology, University of Vienna, Austria.
Grasl
M C
MC
Schima
W
W
Uranitsch
K
K
Piza-Katzer
H
H
Niederle
B
B
Ehrenberger
K
K
Ekberg
O
O
Tscholakoff
D
D
D000714:Anastomosis, Surgical / Q000379:methods; D001466:Barium Sulfate; D002933:Cineradiography; D006801:Humans; D007013:Hypopharynx / Q000000981:diagnostic imaging / Q000601:surgery*; D001239:Inhalation; D007583:Jejunum / Q000637:transplantation*; D007825:Laryngectomy / Q000534:rehabilitation*; D013071:Speech, Alaryngeal / Q000379:methods; D014132:Trachea / Q000000981:diagnostic imaging / Q000601:surgery*; D014743:Videotape Recording
D001466:Barium Sulfate