[Pharyagoesophageal sphinoter myotomy for voice rehabilitation after total laryngectomy].
OBJECTIVE
In those patients received total laryngectomy, Blom-Singer prosthesis speech appears to be the more effective form of rehabilitation. To reduce the effect of pharyngoesophageal sphincter on the Blom-Singer prosthesis voice restoration following total laryngectomy, the pharyagoesphageal sphincter myotomy was designed and carried out.


METHODS
After total laryngectomy, the cricopharyngeus muscle stricture or spasm appears to inhibit the air flowing and prevent the speech. The pharyngoesophageal sphincter is now defined as the area including the cricopharyngeus with a portion of inferior constrictor, as well as some of the upper cervical esophagus. The pharyngoesophageal sphincter were incised intra- and post- operation of total laryngectomy, the dissection was approximately 5 cm in vertical length and 1 cm in width.


RESULTS
Among the 33 patients who received pharyngoesophageal sphincter myotomy following total laryngectomy, voice restoration was achieved in 32 cases, the success rate was 97%. 25 patients had survived for 3 years, 18 patients survived for 5 years.


CONCLUSIONS
Pharyagoesophageal sphincter myotomy can raise the success rate of rehabilitation of the voice by Blom-Singer prosthesis.
Ge
Ping-jiang
PJ
Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China. gepingjiang@yahoo.com.cn
Zhang
Bao-quan
BQ
Gao
Zhi-qiang
ZQ
Peng
Pei-hong
PH
Zhang
Yan
Y
Shi
Xiu-zhen
XZ
Zhang
Lian-shan
LS
D000368:Aged; D004943:Esophagogastric Junction / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000379:methods / Q000534:rehabilitation*; D007831:Larynx, Artificial; D008875:Middle Aged; D010699:Phonation