title: Voice reconstruction using the free ileocolon flap versus the pneumatic artificial larynx: a comparison of patients' preference and experience following laryngectomy.
abstract: This study compares the psychological adjustment and voice function of patients undergoing voice rehabilitation using the free ileocolon flap for creation of a voice tube shunt and patients undergoing voice rehabilitation using the pneumatic artificial larynx. Twelve laryngectomy patients were included; six underwent free ileocolon transfer following a period of pneumatic artificial larynx use. Mean duration after laryngectomy was 5.2 years. Mean follow-up was 210 days. A chart review, questionnaires and a prospective evaluation were performed. Voice tube shunt patients had better speech function and higher self-esteem. People's discrimination and appearance when speaking were important in the patients' choice of method for rehabilitation. There was a high preference for choosing the voice tube shunt and a higher motivation and willingness to use that voice mechanism in the voice tube shunt group. Patients who undergo free flap reconstruction of voice have better speech function and self-esteem than patients who continue to use the external pneumatic device. Psychological assessments are important for surgical patients in order to evaluate a critical aspect of our perceived success - the patients' perception.
authors.affiliation: Department of Plastic and Reconstructive Surgery, E-DA Hospital, I-Shou University, No. 1 Yi-Da Road, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung, Taiwan.
authors.forename: Hung-Chi
authors.initials: HC
authors.lastname: Chen
authors.forename: Samir
authors.initials: S
authors.lastname: Mardini
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Yang
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001007:Anxiety / Q000209:etiology; D003106:Colon / Q000637:transplantation; D003679:Deglutition; D003863:Depression / Q000209:etiology; D004947:Esophagus / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000637:transplantation; D007825:Laryngectomy / Q000523:psychology / Q000534:rehabilitation*; D007831:Larynx, Artificial / Q000523:psychology; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D013071:Speech, Alaryngeal / Q000379:methods*; D013524:Surgical Flaps; D014132:Trachea / Q000601:surgery