[Speech restoration via a tracheo-esophageal tegmental valve fistula following total laryngectomy].
In order to restore the patients' speech function after total laryngectomy, the speech restoration operation has been done successfully in 12 patients with laryngocarcinomas by making tegmental valve fistula from esophageal flap and tracheal tissue after total laryngectomy. First, the trachea and the esophagus were separated, and a tissue flap 20mm in length from posttracheal wall was made. Its upper end was 10mm in width, lower end 8 mm, laterally 5 mm x 6 mm, the tracheal mucosa and cartilage were sewn up to from a tegmental valve, then, a tissue flap 20 mm in length from the preesophageal wall was done with its upper end 15 mm in width, lower end 10 mm. Then a tegmental valve fistula (speech-tube) was made by sewing up two flaps crisscross and a 12F catheter was inserted into the tegmental valve fistula as a supporter for 10 days. Finally, a tracheostomy was performed by sewing up the trachea to the neck skin. All patients could speak fluently and clearly after surgery and kept their sex and dialect characteristics whereas without misswallowing. The operation is a perfect way for total laryngectomy with speech restoration in patients with upper glottal or glottal laryngocarcinomas.
Sun
B
B
Binzhou Prefectural People's Hospital, Shandong.
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D013071:Speech, Alaryngeal / Q000379:methods*; D014139:Tracheostomy / Q000379:methods*