Tracheo-oesophageal party wall thickness in laryngectomised patients in India: implications for surgical voice restoration.
OBJECTIVE
To document accurately the tracheo-oesophageal party wall thickness (PWT) intra-operatively in patients undergoing total laryngectomy and to correlate it with constitutional parameters like height, weight, body mass index (BMI), age, and gender. Also, to correlate PWT with the length of tract (LOT), that is prosthesis size, as measured using the standard valve length measuring device provided by the manufacturers.


METHODS
Twenty-eight patients of carcinoma larynx, following removal of the diseased larynx had their tracheo-oesophageal PWT measured using a special custom-designed and calibrated external (or outside) calliper and a primary trachea-oesophageal puncture (TOP) was made and inserted 10-14 days postoperative with an appropriately sized Blom-Singer(R) indwelling voice prosthesis.


RESULTS
The mean PWT was 3.1 mm. PWT showed significant correlation with the weight of the patients (P = 0.006). There was no significant correlation between PWT and height, BMI, age or gender of the study group. The average LOT was found to be 4.8 mm (SD 1.5). There was a significant correlation (P = 0.009) between PWT and initial LOT, with the most commonly used prosthesis sizes being 4-6 mm.


CONCLUSIONS
The study shows that Indian patients with a thin party wall require a smaller prosthesis size and it is advisable to measure the PWT intra-operatively. Tracheo-oesophageal PWT in laryngectomised patients in India: implications for surgical voice restoration.
Sayed
Suhail I
SI
Department of ENT and Head & Neck Surgery, Grant Medical College and Sir J. J. Group of Hospitals, Mumbai 400008, Maharashtra, India. drsuhailsayed@yahoo.com
Manikantan
Kapila
K
Khode
Shailesh
S
Jagade
Mohan
M
Kasbekar
Vimal G
VG
Shah
Rajen
R
Palav
Rajen S
RS
Nutting
Chris M
CM
Harrington
Kevin J
KJ
Rhys-Evans
Peter
P
Kazi
Rehan
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D014132:Trachea / Q000473:pathology*