title: Voice restoration by primary insertion of indwelling voice prosthesis following circumferential pharyngolaryngectomy with free jejunal graft.
abstract: BACKGROUND
  Voice restoration after circumferential pharyngolaryngectomy (CPL) with free jejunal graft remains a difficult problem to solve. Few reports have analyzed the success rate and complications following primary insertion of indwelling voice prostheses during CPL with free jejunal graft.
  
  
  METHODS
  Eight patients who underwent CPL with free jejunal graft had a Groningen voice prosthesis inserted as a tracheoesophageal (TE) shunt at the time of oncological surgery. A 10-point scale was used to assess each patient's speech intelligibility. Complications following the voice prosthesis insertion were also analyzed.
  
  
  RESULTS
  Six of the eight patients (75%) achieved excellent speech intelligibility and the remaining two patients (25%) were judged as moderate. Six of the eight patients (75%) used the TE shunt as their major means of daily communication. Leakage through or around the prosthesis, which occurred in six (75%) patients, was the most frequent prosthesis-related complication.
  
  
  CONCLUSIONS
  This safe and reliable technique can be effective in improving the quality of life in selected patients undergoing CPL.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-Ku, Sapporo 060-8638, Japan. yfuruta@med.hokudai.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Furuta
authors.forename: Akihiro
authors.initials: A
authors.lastname: Homma
authors.forename: Tatsumi
authors.initials: T
authors.lastname: Nagahashi
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Oridate
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Mesuda
authors.forename: Noriko
authors.initials: N
authors.lastname: Nishizawa
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Sekido
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Okushiba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fukuda
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007583:Jejunum / Q000637:transplantation*; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy / Q000534:rehabilitation*; D011474:Prosthesis Design; D013065:Speech Intelligibility; D013071:Speech, Alaryngeal; D016896:Treatment Outcome