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Near-total laryngectomy with myo-mucosal valved neoglottis

Published online by Cambridge University Press:  29 June 2007

Waryam Singh*
Affiliation:
Broxburn, West Lothian
P. Hardcastle
Affiliation:
Broxburn, West Lothian
*
Waryam Singh, Consultant Otolaryngologist, Department of Otolaryngology, Bangour General Hospital, Broxburn, West Lothian.

Abstract

The entire larynx is usually sacrificed in the process of surgical treatment of T3 glottic carcinoma, trans-glottic carcinoma and pyriform sinus carcinoma, with consequent loss of speech. Most of the uninvolved, cancer-free part of the larynx is discarded for no good reason.

According to the surgical principles of oncology, a tumour should be removed with clear margins, but this does not necessarily mean that the whole organ has to be extirpated. In a recently applied surgical procedure, the small tumour-free part of the larynx is fashioned into an innervated myo-mucosal valved shunt joining trachea and pharynx. This neoglottis allows expiration into the pharynx in speech production but it also contracts during swallowing to avoid aspiration. The first four consecutive cases in which this procedure has been carried out with complete success are presented.

Type
Research Article
Copyright
Copyright © JLO (1984) Limited 1985

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References

Asai, R. (1960) Laryngoplasty. Journal of the Japan Broncho-esophagological Society, 12: 13.Google Scholar
Asai, R. (1972) Laryngoplasty after total laryngectomy. Archives of Otolaryngology, 95: 114119.CrossRefGoogle ScholarPubMed
Calcaterra, T. C. and Jafek, B. W. (1971) Tracheo-oesophageal shunt for speech rehabilitation after total laryngectomy. Archives of Otolaryngology, 94: 124128.CrossRefGoogle ScholarPubMed
Conley, J. J., De Amesti, F. and Pierce, M. K. (1958) A new surgical technique for the vocal rehabilitation of the laryngectomized patient. Annals of Otology, Rhinology and Laryngology, 67: 655664.CrossRefGoogle ScholarPubMed
Conley, J. J. (1959) Vocal rehabilitation by autogenous vein graft. Annals of Otology, Rhinology and Laryngology, 68: 990995.CrossRefGoogle ScholarPubMed
Gluckman, J. L., Donegan, J. O. and Singh, J. (1981) Limitations of the Blom-Singer technique for voice restoration. Annals of Otology, Rhinology and Laryngology, 90: 495497.Google Scholar
Gussenbauer, C. (1874) Uber die erste durch Th. Billroth an Menschen ausgefuhrte kehlkopf-Exstirpation und die Anwendung eines Kunstlichen Kehlkopfes. Verh Deutsch Ges Chir, 17: 343356.Google Scholar
Guttman, M. R. (1935) Tracheo-hypopharyngeal fistulization. A new procedure for speech reproduction in the laryngectomized patients. Transactions of the American Laryngology, Rhinology and Otology Society, 41: 219226.Google Scholar
Komorn, R. M. (1974) Vocal rehabilitation in the laryngectomized patient with a tracheo-eosophageal shunt. Annals of Otology, Rhinology and Laryngology, 83: 445451.CrossRefGoogle ScholarPubMed
Leipzig, B. (1980) Neoglottic reconstruction following total laryngectomy. Annals of Otology, Rhinology and Laryngology, 89: 534537.CrossRefGoogle ScholarPubMed
Miller, A. H. (1967) First experiences with the Asai technique for vocal rehabilitation after total laryngectomy. Annals of Otology, Rhinology and Laryngology, 76: 829833.CrossRefGoogle ScholarPubMed
Miller, A. H. (1971) Four years experience with the Asai technique for vocal rehabilitation for the laryngectomized patient. Journal of Laryngology and Otology, 85: 567576.CrossRefGoogle ScholarPubMed
Montgomery, W. W. (1972) Post laryngectomy vocal rehabilitation. Archives of Otolaryngology, 95: 7683.CrossRefGoogle Scholar
Montgomery, W. W. and Toohill, R. J. (1968) Voice rehabilitation after laryngectomy. Archives of Otolaryngology, 88: 499506.CrossRefGoogle ScholarPubMed
Park, R. (1886) A case of total extirpation of the larynx. Annals of Surgery, 3: 2838.CrossRefGoogle ScholarPubMed
Pearson, B. W. (1981) Subtotal laryngectomy. The Laryngoscope, 91: 19041911.CrossRefGoogle ScholarPubMed
Scuri, M., quoted by Briani, A. A. (1959) Recuperation social des laryngectomises par une method operatoire personnelle. L'Evolution Medicale, 3: 1725.Google Scholar
Singer, M. I. and Blom, E. D. (1980) An endoscopic technique for restoration of voice after laryngectomy. Annals of Otology, Rhinology and Laryngology, 89: 529533.CrossRefGoogle ScholarPubMed
Staffieri, M. (1976) La Chirirgia Riabilitiva Delia Voce Dopo Laringectomia Totale. In: Associazione Otologi Ospedalieri Italiani XXIX. Congresso Nazionale, Bologna, 5: p. 222.Google Scholar
Zwitman, D. and Calcaterra, T. (1973) Phonation using the tracheo-eosophageal shunt. Journal of Speech and Hearing Disorders, 38: 369373.CrossRefGoogle ScholarPubMed