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Subtotal laryngectomy with myomucosal shunt

Published online by Cambridge University Press:  29 June 2007

H. R. Chandrachud ,
M. K. Chaurasia  and
K. P. Sinha
H. R. Chandrachud*
Affiliation:
Consultant in Otolaryngology; Department of Otolaryngology, Gartnavel General Hospital, Glasgow.
M. K. Chaurasia
Affiliation:
Registrar in Otolaryngology; Department of Otolaryngology, Gartnavel General Hospital, Glasgow.
K. P. Sinha
Affiliation:
Erstwhile Registrar in Otolaryngology; Department of Otolaryngology, Gartnavel General Hospital, Glasgow.
*
H. R. Chandrachud, F.R.C.S., Department of Otolaryngology, Gartnavel General Hospital, Glasgow G12.
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Abstract

This is a modified subtotal laryngectomy. On the tumour-free side of the larynx, some posterior structures, with their neurovascular supply are preserved. The endolaryngeal mucosa is tubed in continuity with the trachea below and projects into the pharynx above. Thus a myomucosal shunt is formed. Air is directed into it by finger occlusion of the tracheal stoma.

The voice production is highly satisfactory. Aspiration is prevented by constriction of the thyroarytenoid muscle which provides a valved upper end of the tube.

The possibility of leaving tumour in the laryngeal remnant is eliminated by careful selection of patients, and re-confirmation of tumour extent intra-operatively and a frozen section.

Eleven such operations have been performed since October 1983 for squamous cell carcinoma, some previously irradiated. None of the patients had local recurrence. Only one had an aspiration problem which later resolved. All acquired a satisfactory voice

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 103 , Issue 5 , May 1989 , pp. 504 - 507
Copyright
Copyright © JLO (1984) Limited 1989

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References

Andrews, T. C., Mickel, R. A., Hanson, D. G., Monohan, G. P. and Ward, P. H. (1987) Major complications following tracheo-oeso-phageal puncture for voice rehabilitation. Laryngoscope, 97: 562–567.CrossRefGoogle ScholarPubMed
Asai, R. (1960) Laryngoplasty. Journal of The Japanese Broncho-oesophageal Society, 12: 1–3.Google Scholar
Asai, R. (1972) Laryngoplasty after total laryngectomy. Archives of Otolaryngology, 95: 114–118.CrossRefGoogle ScholarPubMed
Conley, J. J. (1958) A new technique for vocal rehabilitation of the laryngectomized patient. Annals of Otology, Rhinology and Laryngology, 67: 655–659.CrossRefGoogle ScholarPubMed
Kimura, T. Supracricoid Laryngectomy. (1970) A new technique of vocal rehabilitation. Laryngoscope, 80: 300–308.CrossRefGoogle Scholar
Lund, V. J., Perry, A. and Cheeseman, A. D., (1987) Blom Singer puncture (Practicalities in everyday management) Journal of Laryngology and Otology, 101: 164–168.CrossRefGoogle ScholarPubMed
Pearson, B. W. (1980) Extended hemilaryngectomy for T3 glottic carcinoma with preservation of speech and swallowing. Laryngoscope, 90: 1950–1961.CrossRefGoogle ScholarPubMed
Pearson, B. W. (1981) Subtotal laryngectomy. Laryngoscope, 91: 1904–1912.CrossRefGoogle ScholarPubMed
Shaw, H. J., (1987) A view of partial laryngectomy in treatment of laryngeal cancer. Journal of laryngology and Otology, 101: 143–154.CrossRefGoogle ScholarPubMed
Silver, F. M., Glucksman, J. L. and Donegan, J. O. (1985) Operative complications of tracheo-oesophageal puncture. Laryngoscope, 95: 1360–1362.CrossRefGoogle Scholar
Singer, M. T. and Blom, E. D. (1980) An endoscopic technique for restoration of voice after total laryngectomy. Annals of Otology, Rhinology and Laryngology, 89: 529–533.CrossRefGoogle Scholar
Singh, W. (1985) Near total laryngectomy with myomucosal valved neoglottis. Journal of Laryngology and Otology, 99: 581–588.Google ScholarPubMed