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Optimal ileocolic flap length for a reconstructed voice tube after laryngopharyngectomy

Published online by Cambridge University Press:  12 October 2015

Y-A Tsou ,
T-S Li ,
M-H Tsai ,
H-C Chen  and
P Belafsky
Y-A Tsou
Affiliation:
Department of Otolaryngology Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
T-S Li
Affiliation:
Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan
M-H Tsai
Affiliation:
Department of Otolaryngology Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
H-C Chen*
Affiliation:
Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan
P Belafsky
Affiliation:
Voice and Swallow Center, University of California, Davis, USA
*
Address for correspondence: Dr Hung-Chi Chen, Department of Plastic Surgery, China Medical University Hospital, Yuh-Der Road, No. 2, Taichung, Taiwan E-mail: [email protected]
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Abstract

Background:

Voice restoration after laryngopharyngectomy can be achieved with an autologous ileocolic flap. We have observed that the length of the flap influences vocal outcome. This investigation aimed to evaluate the association between ileocolic flap length and vocal quality after laryngopharyngectomy.

Methods:

The charts of patients who underwent voice rehabilitation with an ileocolic flap after laryngopharyngectomy between 1 January 2011 and 30 December 2012 were abstracted. The length of ileum segment in the ileocolic flap was stratified, and voice outcome was evaluated three months post-operatively, while adjusting for confounding variables.

Results:

There was a significant association between flap length and loudness, maximum phonation time and sound pressure level (p < 0.05). All three parameters were best in the 10 cm length group.

Conclusion:

Voice rehabilitation after laryngopharyngectomy is possible with an ileocolic flap. The optimal ileocolic flap contains a 10 cm ileum segment. Complications are frequent but amenable to revision surgery.

Keywords

Ileocolic FlapPharyngectomyLaryngectomyHypopharyngeal NeoplasmVoice Disorder
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 2 , February 2016 , pp. 190 - 193
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented at the 2013 American Society for Reconstructive Microsurgery annual meeting, 12–15 January 2013, Naples, Florida, USA.

References

1Chen, HC, Gharb, BB, Rampazzo, A, Perrone, F, Chen, SH, Trignano, E. Simultaneous restoration of voice function and digestive tract continuity in patients with synchronous primaries of hypopharynx and thoracic esophagus with pedicled ileocolon flap. Surgery 2011;149:662–71CrossRefGoogle ScholarPubMed
2Hsiao, HT, Leu, YS, Chang, YC, Yang, JC, Tung, KY. Voice and swallowing after laryngopharyngectomy and free ileocolic flap reconstruction for hypopharyngeal cancer. Ann Plast Surg 2009;62:390–4CrossRefGoogle ScholarPubMed
3Reumueller, A, Leonhard, M, Mancusi, G, Gaechter, JN, Bigenzahn, W, Schneider-Stickler, B. Pharyngolaryngectomy with free jejunal autograft reconstruction and tracheoesophageal voice restoration: indications for replacements, microbial colonization, and indwelling times of the Provox 2 voice prostheses. Head Neck 2011;33:1144–53CrossRefGoogle ScholarPubMed
4Rossmiller, SR, Ghanem, TA, Gross, ND, Wax, MK. Modified ileocolic free flap: viable choice for reconstruction of total laryngopharyngectomy with total glossectomy. Head Neck 2009;31:1215–19CrossRefGoogle ScholarPubMed
5Cocuzza, S, Bonfiglio, M, Grillo, C, Maiolino, L, Malaguarnera, M, Martines, F et al. Post laryngectomy speech rehabilitation outcome in elderly patients. Eur Arch Otorhinolaryngol 2013;270:1879–84CrossRefGoogle ScholarPubMed
6Hancock, KL, Lawson, NR, Ward, EC. Device life of the Provox Vega voice prosthesis. Eur Arch Otorhinolaryngol 2013;270:1447–53CrossRefGoogle ScholarPubMed
7Imaizumi, A, Liem, A, Ngo, Q, Chen, HC. Free jejunal diversionary conduit flaps following radiation damage to the pharynx: a technique for regaining oral feeding while preserving vocal function. J Plast Reconstr Aesthet Surg 2012;65:620–8CrossRefGoogle Scholar
8Tuomi, L, Bjorkner, E, Finizia, C. Voice outcome in patients treated for laryngeal cancer: efficacy of voice rehabilitation. J Voice 2014;28:62–8CrossRefGoogle ScholarPubMed
9Plant, RL, Freed, GL, Plant, RE. Direct measurement of onset and offset phonation threshold pressure in normal subjects. J Acoust Soc Am 2004;116:3640–6CrossRefGoogle ScholarPubMed