title: Detection of ideal reservoir level after laryngectomy using endoilluminator in voice rehabilitation.
abstract: OBJECTIVE
  To assess the diagnostic value of a novel device, the endoilluminator, in patients who can or cannot attain effective speech after application of voice prosthesis.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Thirty-four patients who underwent total laryngectomy and whose insufflation test was positive were included. As a result of efforts to develop an insufflation test that includes a light apparatus, we attained a device that we call an endoilluminator. We found that the area it illuminated when a patient achieved effective speech was a predictive factor for the test result. That is, patients for whom the upper part of the tracheostomy (where the standard tracheoesophageal fistula will be opened) was illuminated were categorized as the positive test group, whereas those for whom the neck skin above this region was illuminated were categorized as the negative test group.
  
  
  RESULTS
  In 27 of the 34 patients, appropriate localization was determined using the endoilluminator, and these patients achieved effective speech. In the remaining seven patients, localization was inappropriate and they did not achieve effective speech during the first week, first month, or third month postpuncture. In further investigations of these seven patients, a pharyngoesophageal spasm was detected in five, and a pharyngoesophageal stricture was detected in two.
  
  
  CONCLUSIONS
  Endoilluminator increases the success rate of the insufflation test by accurately predicting a patient's ability to achieve effective speech after application of voice prosthesis.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery (ORL&HNS), Bakırkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ali Ahmet
authors.initials: AA
authors.lastname: Sirin
authors.affiliation: Department of ORL & HNS, Tokat Erbaa State Hospital, Tokat, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Erdim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery (ORL&HNS), Bakırkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
authors.forename: Bahadir
authors.initials: B
authors.lastname: Baykal
authors.affiliation: Department of ORL & HNS, Dumlupinar University, Faculty of Medicine, Kutahya, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Oghan
authors.affiliation: Department of Neurotology, the University of Miami, Miller School of Medicine, Miami, Florida, U.S.A.
authors.forename: Rasim
authors.initials: R
authors.lastname: Yilmazer
authors.affiliation: Department of ORL & HNS, Cankiri State Hospital, Cankiri, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Guvey
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery (ORL&HNS), Bakırkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
authors.forename: Fatma Tulin
authors.initials: FT
authors.lastname: Kayhan
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013071:Speech, Alaryngeal / Q000295:instrumentation*; D014831:Voice / Q000502:physiology*; D014833:Voice Quality
keywords: Endoilluminator; insufflation; voice prosthesis