Speech results and complications of near-total laryngectomy.
Near-total laryngectomy provides a functional alternative to total laryngectomy in selected cases of laryngeal and hypopharyngeal cancer. We report our experience with the first 49 patients treated with near-total laryngectomy over a 3-year period. Successful speech rehabilitation was obtained in 79.5% of the patients in a median time of 40 days. Speech was acquired in 89.6% of the patients with follow-up longer than 6 months. Hands-free conversation was possible in 51.4% of the speaking patients. Five patients had symptomatic aspiration and 23 developed postoperative pharyngocutaneous fistula. Four local recurrences occurred in the laryngeal remnant. These results confirm that near-total laryngectomy provides a relatively safe, simple, and reproducible speech rehabilitation method for patients in whom total laryngectomy otherwise would be required.
Gavilán
J
J
Department of Otorhinolarygology, La Paz Hospital, Autonomous University, Madrid, Spain.
Herranz
J
J
Prim
J
J
Rabanal
I
I
D017577:Cutaneous Fistula / Q000453:epidemiology*; D005402:Fistula / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects* / Q000379:methods / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010608:Pharyngeal Diseases / Q000453:epidemiology*; D013071:Speech, Alaryngeal; D013997:Time Factors