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Journal articles on the topic 'Laryngectomie reconstructive'

Author: Grafiati

Published: 4 June 2021

Last updated: 5 February 2022

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1

Krajina, Z. "Vertical partial laryngectomy on demand." Journal of Laryngology & Otology 104, no. 11 (November 1990): 879–82. http://dx.doi.org/10.1017/s0022215100114239.

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AbstractThe author proposes the term ‘vertical partial laryngectomy on demand’ for all modifications of vertical laryngectomics (frontal, frontolateral, vertical and hemilaryngectomy). This term includes two conditions: the first is complete oncological removal of the tumour (proven by histological examination and with the use of magnification or the operating microscope during the operation); secondly, reconstruction of the laryngeal defect by various procedures. The author uses the sternohyoid fascia in vertical and frontolateral partial laryngectomies. From 120 operated cases, a five-year survival rate of 81 per cent was achieved. The fascia showed resistance to post-operative complications and irradiation.

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2

Djordjevic, Vladimir, Jovica Milovanovic, Zeljko Petrovic, Zoran Dudvarski, B. Petrovic, and P. Stankovic. "Radical surgery of the malignantlaryngeal tumors." Acta chirurgica Iugoslavica 51, no. 1 (2004): 31–35. http://dx.doi.org/10.2298/aci0401031d.

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Modem therapeutical protocols for treatment of T3 and T 4 malignomas of the larynx are not adjusted, because there are attempts to treat these diseases with non-operative methods (such as chemo- and radiotherapy) in order to preserve the organ. The aim of the study was to establish today's results of the surgical treatment of patients with T3 and T4 laryngeal malignoma. We studied the group of patients with laryngeal carcinoma, who had undergone total laryngectomy, during the period of eight years (1990-1997). The patients' data was submitted from medical documentation, it was filled in specially designed questionnaires and was statistically reviewed. During this eight-year-period. 1054 total laryngectomies were done. The five-years survival rate, established in the group of patients who had undergone total laryngectomiy is 308/794 (39%). In the patient group where total laryngectomy was salvage surgery after radiotherapy, the five-years survival rate is 47/172 (27%). In the patient group where total laryngectomy was salvage surgery after conservative or reconstructive surgery, the five-years survival rate is 28/84 (33%). Despite diagnostical and therapeutical achievements, prognosis for T3 and T4 malygnoma of the larynx was not significantly approved in the last few decades.

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3

Maclean, J., S. Cotton, and A. Perry. "Variation in surgical methods used for total laryngectomy in Australia." Journal of Laryngology & Otology 122, no. 7 (July 2008): 728–32. http://dx.doi.org/10.1017/s0022215108002119.

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AbstractDeglutition disorders (dysphagia) are common following total laryngectomy. As the aetiology of the disorder is poorly understood, its incidence is probably under-estimated. Dysphagia may result from many factors, including the type of laryngectomy surgery employed and the use of adjuvant treatments (e.g. radiotherapy and chemotherapy). Dysphagia may also be compounded by other co-morbid factors, such as ageing and depression.Aim:To investigate the methods of surgical closure used by Australian ENT and head and neck surgeons after undertaking total laryngectomy surgery.Method:In order to audit surgical variation, 56 short questionnaires were sent to all Australian ENT and head and neck surgeons who were registered members of the Australia and New Zealand Head and Neck Society. Twenty-eight questionnaires (50 per cent) were completed and returned.Results:Respondents reported using a variety of different reconstructive methods after total laryngectomy surgery. Specifically, there were differences in the type and levels of pharyngeal closure employed and the suturing techniques used.Conclusion:Currently, there is no scientific evidence to direct surgeons to the optimal pharyngeal reconstruction technique(s) ensuring for good swallowing results post-laryngectomy. An analysis of the effect of surgical reconstruction technique on laryngectomees' post-operative swallowing ability is needed, in order to provide evidence to determine optimal surgical techniques.

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4

Varghese, B. T., and P. Sebastian. "Treatment outcome in patients undergoing surgery for carcinoma larynx and hypopharynx: A follow-up study." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 15545. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.15545.

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15545 Background: In the Regional Cancer Centre (RCC) Trivandrum, India, carcinoma of the larynx account for approximately 5% of all new registries and carcinoma of the hypopharynx for another 3%. It is estimated that the division of surgical oncology RCC has performed about 200 laryngectomies since it’s beginning (1989). Currently i.e. after the year 2000,about 30–40 laryngectomies are estimated to be performed a year thus forming about 3–4% of overall major head and neck surgeries performed which is around 1000 cases per year. 80% of these surgeries are salvage procedures for failed radical radiation/chemoradiation. Aim: (1) To evaluate the role of surgery in disease free and overall survival. (2) To evaluate the prognostic significance of factors that generally affect the surgical outcome in laryngectomies. (3) To evaluate the morbidity associated with salvage surgeries and laryngectomies involving complex reconstructions. (4) To follow up all the patients and evaluate quality of life. (5) To evolve a protocol for selecting cases for primary and salvage laryngectomy. (6) To evolve a protocol for reconstructing the pharynx after laryngectomies. Methods: All patients who have undergone laryngectomy at the Division of Surgical Oncology RCC from June 1995 to Dec 2005 are included in the study which retrospectively records the age and sex distribution initial TNM staging and staging of recurrence/ residual disease at the time of surgical salvage, the indications and types of laryngectomy, and reconstructive options used and analyze the therapeutic outcome, disease free survival (DFS), overall survival (OS), voice preservation, post operative voice rehabilitation and quality of life. Major outcome measures Complications and factors contributing to it, DFS, OS, Voice Preservation, Postoperative rehabilitation and Quality of life. Results and Conclusions: An update of the results as on 31/12/05 the final conclusions and recommendations will be presented.( The study is currently on going with the Institutional Review Board (IRB) and the local Ethical committee (EC) clearance already obtained.and final document is expected to to be prepared by March 2006). No significant financial relationships to disclose.

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Jovic, Rajko. "One thousand laryngectomies performed at the Novi Sad University ENT clinic: Historical review and important data on treatment of laryngeal tumors." Medical review 58, no. 1-2 (2005): 89–93. http://dx.doi.org/10.2298/mpns0502089j.

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Introduction. The first EKT Department in Novi Sad was established in 1926. In I960 the ENT Clime became a part of the Facility of medicine Novi Sad and treatment of malignant disease started in 1973 at the Laryngology Department. Surgical treatment of malignant laryngeal tumors. Treatment of laryngeal cancers in Novi Sad started in 1960's. Until 1971, the treatment of choice was radiotherapy, and surgical treatment started in 1971, when the first laryngectomy was performed. After the first surgery, 31 years have passed until we have reached the number of one thousand performed laryngectomies at ENT Clinic in Novi Sad. Period: 1971-1988. During this period, 138 laryngectomies were performed at ENT Clinic. Total laryngectomies were done as salvage surgeries in 136 cases, and 2 patients underwent functional partial lariigectomies. Direct laryngomicroscopy was introduced by Zivko Majdevac in 1972. Oncology consilium was founded. Period: 1990-2002. New protocol was adopted. Surgery became me primary treatment of laryngeal carcinoma, while radiotherapy remained a valid therapeutic alternative. All known surgical techniques were introduced, including Pearson's near-total laryngectomy. In this period 834 patients were operated, and 873 laryngectomies were performed, out of which 388 total laryngectomies. Year after year the number of patients increased and in 2002. 90 laryngectomies were performed. The number of functional reconstructive operations has increased to 67.8% in comparison to 32.2 % of total laryngectomies. .

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6

Hagen, Rudolf, Burkard Schwab, and Sabine Marten. "Nasotracheal Airway-Oropharyngeal Alimentary Canal: A Microvascular Technique for Reconstruction of the Upper Airway after Total Laryngectomy." Annals of Otology, Rhinology & Laryngology 104, no. 4 (April 1995): 317–22. http://dx.doi.org/10.1177/000348949510400412.

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Every patient who has to be laryngectomized because of a carcinoma is concerned with the loss of his or her voice and the presence of a permanent tracheostoma in his or her neck. While various methods for producing a substitute voice are available (esophageal voice, voice devices, voice-shunt operations with or without voice prosthesis), it is usually impossible after laryngectomy to reconstruct a complete upper airway so that the tracheostoma can be closed. One potential method for reconstruction of the airway is its division into a nasotracheal airway and an oropharyngeal alimentary canal. Ten Alsatian dogs were laryngectomized, and a microvascularly anastomosed jejunal autograft was inserted as a junction between the tracheal stump and the circularly exposed nasopharynx, while the pharynx was reconstructed separately. One week postoperatively, oral feeding could be started again; at the same time breathing was possible via the reconstructed nasotracheal airway, which was kept open by insertion of a silicone tube. By means of this microvascular technique, a complete nasal airway could be reconstructed surgically after laryngectomy.

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Sokoya, Mofiyinfolu, Arash Bahrami, Aurora Vincent, Jared Inman, Moustafa Mourad, Raja Sawhney, and Yadranko Ducic. "Pharyngeal Reconstruction with Microvascular Free Tissue Transfer." Seminars in Plastic Surgery 33, no. 01 (February 2019): 078–80. http://dx.doi.org/10.1055/s-0039-1677877.

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AbstractReconstruction of pharyngoesophageal defects after total laryngectomies and extirpation of hypopharyngeal and upper esophageal carcinomas presents a challenging task. Goals of reconstruction include adequate voice rehabilitation and restoration of normal swallowing. The reconstructive armamentarium contains many options for reconstruction and creation of a new upper digestive tract. This review article focuses on the most commonly used free tissue transfer options for the reconstruction of these defects, with an assessment of their advantages and disadvantages.

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8

Liu, Chen, Paul H. Ward, and Lawrence Pleet. "Imbrication Reconstruction following Partial Laryngectomy." Annals of Otology, Rhinology & Laryngology 95, no. 6 (November 1986): 567–71. http://dx.doi.org/10.1177/000348948609500605.

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Experience over a 16-year period with 38 patients who underwent partial laryngectomy with imbrication reconstruction is reviewed. We have found this technique to be an expeditious and highly successful means of eradicating T1 or T2 glottic cancer. The use of the patient's own full-thickness, adjacent normal tissue with imbrication of cartilage produces an adequate airway, an almost normal-appearing larynx, and a remarkable posttreatment voice quality, better results than from most cordectomies or vertical hemilaryngectomies. It is valuable as a salvage procedure after full-course radiation. Imbrication laryngoplasty is an alternative and a preferred modality for treatment of young people with early glottic carcinoma for whom the possible carcinogenic properties of radiation must be considered. The survival results are comparable with the more extensive vertical laryngectomies.

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9

Gupta, Devendra Kumar, Rajeev Chugh, Sanajeet Kumar Singh, and Seema Pati. "Use of the facial artery-based cutaneous island flap (melo-labial flap) for reconstruction of the neopharynx following total laryngectomy: a novel technique." BMJ Case Reports 12, no. 8 (August 2019): e230712. http://dx.doi.org/10.1136/bcr-2019-230712.

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Reconstruction of neopharynx after total laryngectomy is a challenging task. Various locoregional flaps like pectoralis major myocutaneos/ latismus dorsi flaps and free flaps have their own limitations and advantages. To overcome this, we used facial artery-based cutaneous island flap (melo-labial flap) for reconstruction of the neopharynx following total laryngectomy (DK Gupta technique). This flap is thin, pliable, without any gravitational pull and without any risk of anastomosis failure and hence has advantage of both locoregional and free flaps and eliminates the limitations of both. It is simple, reproducible and reliable reconstructive option for neopharynx. We present a case report, review of literature and this novel technique for an excellent outcome and recommend to use it as the new workhorse of neopharyngeal reconstruction.

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10

Ragbir, M., J. S. Brown, and H. Mehanna. "Reconstructive considerations in head and neck surgical oncology: United Kingdom National Multidisciplinary Guidelines." Journal of Laryngology & Otology 130, S2 (May 2016): S191—S197. http://dx.doi.org/10.1017/s0022215116000621.

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AbstractThis is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The reconstructive needs following ablative surgery for head and neck cancer are unique and require close attention to both form and function. The vast experience accrued with microvascular reconstructive surgery has meant a significant expansion in the options available. This paper discusses the options for reconstruction available following ablative surgery for head and neck cancer and offers recommendations for reconstruction in the various settings.Recommendations• Microsurgical free flap reconstruction should be the primary reconstructive option for most defects of the head and neck that need tissue transfer. (R)• Free flaps should be offered as first choice of reconstruction for all patients needing circumferential pharyngoesophageal reconstruction. (R)• Free flap reconstruction should be offered for patients with class III or higher defects of the maxilla. (R)• Composite free tissue transfer should be offered as first choice to all patients needing mandibular reconstruction. (R)• Patients undergoing salvage total laryngectomy should be offered vascularised flap reconstruction to reduce pharyngocutaneous fistula rates. (R)

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11

Garozzo, A., and M. Rossi. "Glottic reconstruction by implant of homologous laryngeal cartilages." Journal of Laryngology & Otology 107, no. 5 (May 1993): 427–29. http://dx.doi.org/10.1017/s0022215100123333.

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This paper describes a case of reconstructive laryngectomy in a patient with epidermoid carcinoma of the glottis. Reconstruction of the skeletal laryngeal architecture was carried out by implanting homologous cartilages, whilst the glottis was reconstructed with sternohyoid muscle. Laryngeal function was restored within 30 days of the operation.

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12

Alajmo, E., G. Polli, and Ceilia Salimbeni. "Reconstructive laryngectomy." Journal of Laryngology & Otology 99, no. 5 (May 1985): 463–70. http://dx.doi.org/10.1017/s002221510009705x.

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13

Wang, Ching-Ping, Tzu-Chan Tseng, Rheun-Chuan Lee, and Shyue-Yih Chang. "The techniques of nonmuscular closure of hypopharyngeal defect following total laryngectomy: the assessment of complication and pharyngoesophageal segment." Journal of Laryngology & Otology 111, no. 11 (November 1997): 1060–63. http://dx.doi.org/10.1017/s0022215100139337.

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AbstractThe usual method of reconstructing a hypopharyngeal defect during total laryngectomy includes pharyngeal muscle layer closure, which may result in high pharyngoesophageal pressure. We hypothesize that nonclosure of the pharyngeal muscle can reduce the pressure of the pharyngoesophageal segment which can reduce the chances of the formation of pharyngocutaneous fistulae. A technique of nonmuscular closure of a hypopharyngeal defect is presented. The differences in the rate of fistula formation and swallowing function between patients with usual and nonmuscular closure were also studied. Sixty consecutive laryngectomees were enrolled in this study. Thirty patients received usual closure after total laryngectomy, whereas the other 30 patients underwent non closure of their pharyngeal muscles. One patient (3.3 per cent) in the nonmuscular closure group and three patients (10 per cent) in the usual closure group developed a pharyngocutaneous fistula. The pharyngoesophageal pressures of the nonmuscular closure group were significantly lower than those of the usual closure group. We conclude that the technique of nonclosure of the pharyngeal constrictor muscle after total laryngectomy is relatively more simple and is not associated with a higher rate of fistula formation. Furthermore, nonclosure of the pharyngeal constrictor muscle is preferable to muscular closure because it reduces the spasm of the pharyngoesophageal segment which limits voice rehabilitation.

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14

Keser, Riza, Alp Desmireller, and Gursel Dursun. "Supracricoid Reconstructive Laryngectomy." Otolaryngology–Head and Neck Surgery 112, no. 5 (May 1995): P103. http://dx.doi.org/10.1016/s0194-5998(05)80253-0.

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DEMIRELLER, A., M. SAATCI, and Y. AKBAS. "Subtotal reconstructive laryngectomy." Otolaryngology - Head and Neck Surgery 117, no. 2 (August 1997): P195. http://dx.doi.org/10.1016/s0194-5998(97)80425-1.

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Consalici, R., and D. Dall'Olio. "Severe laryngeal fracture treated by supracricoid laryngectomy." Journal of Laryngology & Otology 124, no. 11 (June 11, 2010): 1239–41. http://dx.doi.org/10.1017/s0022215110001374.

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AbstractObjective:To report a rare case of severe laryngeal fracture treated by supracricoid laryngectomy. Previously, a few cases of major laryngeal trauma treated by reconstructive laryngectomy have been briefly described. This paper aims to comprehensively document a rare case of severe laryngeal fracture for which this difficult treatment choice represented an acceptable option.Methods:A 33-year-old woman sustained very serious blunt laryngeal trauma. The complexity of the laryngeal injuries led us to opt for supracricoid laryngectomy, rather than to attempt laryngeal repair.Results:The post-operative course was normal. The patient's post-operative voice was breathy but functional. No airway stenoses occurred.Conclusion:For severe laryngeal fractures, reparative procedures and stenting constitute the standard treatment. However, in selected and especially critical cases, a primary partial or reconstructive laryngectomy is justifiable.

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Gadepalli, C., C. de Casso, S. Silva, S. Loughran, and J. J. Homer. "Functional results of pharyngo-laryngectomy and total laryngectomy: a comparison." Journal of Laryngology & Otology 126, no. 1 (August 26, 2011): 52–57. http://dx.doi.org/10.1017/s0022215111002313.

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AbstractObjective:To compare the key functional results (regarding swallowing and voice rehabilitation) in patients treated by pharyngo-laryngectomy with flap reconstruction, versus standard, wide-field, total laryngectomy.Method:We studied 97 patients who had undergone total laryngectomy and pharyngo-laryngectomy with flap reconstruction. The main outcome measures were swallowing (i.e. solid food, soft diet, fluid or enteral feeding) and fluent voice development.Results:There were 79 men and 18 women, with follow up of one to 19 years. Voice (p = 0.037) and swallowing (p = 0.041) results were significantly worse after circumferential pharyngo-laryngectomy than after non-circumferential pharyngo-laryngectomy. There was no significant difference in voice (p = 0.23) or swallowing (p = 0.655) results, comparing total laryngectomy and non-circumferential pharyngo-laryngectomy. The presence of a post-operative fistula significantly influenced voice (p = 0.001) and swallowing (p = 0.009) outcomes.Conclusion:The additional measures involved in pharyngo-laryngectomy do not confer any functional disadvantage, compared with total laryngectomy, but only if the procedure is non-circumferential. Functional results of circumferential pharyngo-laryngectomy are worse than those of both non-circumferential pharyngo-laryngectomy and total laryngectomy. If oncologically possible and safe, it is better to keep a pharyngo-laryngectomy non-circumferential.

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Balasubramanian, Deepak, Narayana Subramaniam, Priyank Rathod, Samskruthi Murthy, Mohit Sharma, Jimmy Mathew, Krishnakumar Thankappan, and Subramania Iyer. "Outcomes following pharyngeal reconstruction in total laryngectomy – Institutional experience and review of literature." Indian Journal of Plastic Surgery 51, no. 02 (May 2018): 190–95. http://dx.doi.org/10.4103/ijps.ijps_79_17.

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ABSTRACT Background: Pharyngeal reconstruction is a challenging aspect of reconstruction after resections for head-and-neck cancer. The goals of reconstruction are to restore the continuity of the pharyngeal passage to enable oral alimentation and rehabilitation of speech wherever possible. This study was performed to determine the outcomes following pharyngeal reconstruction in total laryngectomy (TL) using different reconstructive options and to determine the predictors of pharyngocutaneous fistula (PCF) and swallowing dysfunction. Materials and Methods: Retrospective analysis of patient data between 2003 and 2010 of patients undergoing TL with partial or total pharyngectomy. Demographic and treatment details were collected and analysed. Univariate analysis was performed to determine predictors of PCF and swallowing dysfunction. Results: Fifty-seven patients underwent pharyngeal reconstruction following TL, 31 of whom had received prior treatment. Following tumour resection, 31 patients had circumferential defects and 26 patients had partial pharyngeal defects. The flaps used include pectoralis major myocutaneous flap (n = 29), anterolateral thigh flap (n = 8), gastric pull-up (n = 13) and free jejunal flap (n = 7). PCF was seen in 20 patients, of which 15 (75%) were managed conservatively and 5 required another surgery. At last follow-up, 99 patients (68%) were on full oral alimentation. Tracheo-oesophageal puncture and prosthesis insertion was done in 20 patients, of whom 17 (85%) developed satisfactory speech. Partial pharyngeal defects were associated with a higher risk of PCF on univariate analysis (P = 0.006) but were not significant on multivariate analysis. Post-operative swallowing dysfunction was significantly higher with hypopharyngeal involvement by tumour (P = 0.003). Conclusion: Pharyngeal reconstruction in TL is feasible with good results. Majority of the patients swallow and regain acceptable swallowing function within 3 months.

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Yeh, David H., Axel Sahovaler, and Kevin Fung. "Reconstruction after salvage laryngectomy." Oral Oncology 75 (December 2017): 22–27. http://dx.doi.org/10.1016/j.oraloncology.2017.10.009.

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Chepeha, Douglas B., Matthew M. Hanasono, Urjeet Patel, Eric M. Genden, Andrew Rosco, and Eric Chanowski. "Reconstruction after Salvage Laryngectomy." Otolaryngology–Head and Neck Surgery 149, no. 2_suppl (August 23, 2013): P19. http://dx.doi.org/10.1177/0194599813493390a40.

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Thompson, C. S. G., P. Asimakopoulos, A. Evans, G. Vernham, A. J. Hay, and I. J. Nixon. "Complications and predisposing factors from a decade of total laryngectomy." Journal of Laryngology & Otology 134, no. 3 (February 21, 2020): 256–62. http://dx.doi.org/10.1017/s0022215120000341.

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AbstractBackgroundTotal laryngectomy is often utilised to manage squamous cell carcinoma of the larynx or hypopharynx. This study reports on surgical trends and outcomes over a 10-year period.MethodA retrospective review of patients undergoing total laryngectomy for squamous cell carcinoma was performed (n = 173), dividing patients into primary and salvage total laryngectomy cohorts.ResultsA shift towards organ-sparing management was observed. Primary total laryngectomy was performed for locoregionally advanced disease and utilised reconstruction less than salvage total laryngectomy. Overall, 11 per cent of patients developed pharyngocutaneous fistulae (primary: 6 per cent; salvage: 20 per cent) and 11 per cent neopharyngeal stenosis (primary: 9 per cent; salvage: 15 per cent). Pharyngocutaneous fistulae rates were higher in the reconstructed primary total laryngectomy group (24 per cent; 4 of 17), compared with primary closure (3 per cent; 3 of 90) (p = 0.02). Patients were significantly more likely to develop neopharyngeal stenosis following pharyngocutaneous fistulae in salvage total laryngectomy (p = 0.01) and reconstruction in primary total laryngectomy (p = 0.02). Pre-operative haemoglobin level and adjuvant treatment failed to predict pharyngocutaneous fistulae development.ConclusionComplications remain hard to predict and there are continuing causes of morbidity. Additionally, prior treatment continues to affect surgical outcomes.

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Azad, Muhammad Ali, Belayat H. Siddiquee, AKM Asaduzzaman, Faisal Bin Mohsin, and Mohammad Abul Hasnat. "Surgical Outcome and Quality of Life After Total Laryngectomy in Advanced Laryngeal Cancer- A Study in Combined Military Hospital, Dhaka." Bangladesh Journal of Otorhinolaryngology 27, no. 1 (April 28, 2021): 5–11. http://dx.doi.org/10.3329/bjo.v27i1.53199.

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Introduction: Total laryngectomy is the gold standard treatment for advanced laryngeal cancer. Sacrifice of voice is one of the most important shortcomings of the procedure. Possibility of achieving good quality voice is greater with prosthesis compared to other method. Post laryngectomy voice rehabilitation with prosthesis yield excellent outcome in most of the cases. Swallowing, pulmonary and olfactory rehabilitation should be managed by multidisciplinary team for better quality of life (QoL). Objectives: The purpose of this study was to observe the outcomes of voice, swallowing pulmonary and olfactory rehabilitation and QoL following total laryngectomy. Methods: This cross sectional retrospective clinical study was conducted at the Head & Neck Oncology Unit, Combined Military Hospital (CMH), Dhaka. Total 57 candidates were selected. Diagnosis was done by thorough clinical examination, Fibre Optic Laryngoscopy. Contrast Enhanced Computed Tomography (CECT) scan of neck was done except few cases where MRI of neck was done for subtle cartilage erosion was suspected. Examination under anaesthesia, direct larangoscopy and biopsy was done for every cases. Candidates were post chemo-radiated/ radiated biopsy proven recurrent cases, clinically nonfunctional larynx with aspiration and radiologically evident of cartilage erosion. In all cases artificial voice prosthesis was used. All the laryngectomees underwent voice, swallowing, pulmonary and olfactory rehabilitation in laryngectomy club of head & neck oncology unit, CMH Dhaka for a period of 3 months as per standard protocol. Results: Among the 57 patients 42 of them are using voice prosthesis without any complications till to date. Voice rehabilitation started after wound healing & developed meaningful voice in around 6 weeks. Satisfactory speech & voice outcomes were observed near about 3 months. Voice quality was assessed by multivariate statistical analysis. Excellent voice was observed for 38 patients, good voice for 12 patients, fair voice for 05 patients and poor voice for 02 patients. Troubleshooting like mycotic infection developed in 6 patients which was managed by anti-fungal medication with regular appropriate cleaning, Pharyngocutaneous fistula developed in 5 patients, 3 healed later by pressure dressing and anticholinergic & 1 required exploration and flap reconstruction, 01 developed recurrent stomal stenosis which managed surgically by Y-V advancement. Prosthesis expelled out in 3 cases. 02 cases developed dysphagia due to tonicity of pharyngoesophageal (PE) segment & managed by botox injection. Significantly better voice & swallowing were reported by patients undergone laryngectomy alone in comparison with patients receiving adjuvant radiotherapy & patient undergoing salvage laryngectomy. Conclusion: Awareness should be developed as sacrifice of voice box is no more a permanent comorbidity of total laryngectomy. Excellent voice can be developed by insertion of voice prosthesis as well as swallowing pulmonary and olfactory rehabilitation following laryngectomy for better of QoL. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 5-11

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23

Ratushny, M. V., A. P. Polyakov, A. D. Kaprin, I. V. Reshetov, I. V. Rebrikova, and A. V. Mordovskiy. "MODERN CRITERIA FOR THE SELECTION OF HEAD AND NECK CANCER PATIENTS FOR RECONSTRUCTION OF THE UPPER AERODIGESTIVE TRACT BY THE VISCERAL FLAPS." Siberian journal of oncology 20, no. 3 (June 29, 2021): 28–38. http://dx.doi.org/10.21294/1814-4861-2021-20-3-28-38.

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Introduction. The high incidence of cancer of the upper aerodigestive tract, impairment of breathing, speech, and swallowing functions accompanied by prolonged and often persistent disability put the rehabilitation and the quality of life of patients among the most important social problems.Material and methods. We have gained experience in reconstructing the pharynx and esophagus with various fragments of the gastrointestinal tract in 121 cancer patients. Based on our own clinical experience, the most important criteria of selecting patients after laryngectomy for reconstruction of the upper aerodigestive tract with visceral flaps were identified. Visceral autografts formed from different parts of the patient’s gastrointestinal tract were full-layer fragments of the abdominal organs, which included the mucous membrane of the stomach, small intestine, or large intestine. In some patients, the choice of flap was limited by a large omentum.Results. In 9.9 % of cases, flap necrosis was observed. Oral nutrition was restored in 93.9 % of patients. In 90.5 % of cases, speech function was restored after the installation of avoice prosthesis. The method of autologous transplantation of the ileo-colonic flap made it possible not only to remove the organs affected by the tumor, but also to simultaneously restore the lost nutrition and vocal functions without resorting to artificial prostheses, but using only their own tissues. The 5-year survival rates were 36.4 % and 67.3 % in patients with simultaneous reconstruction and in patients with delayed reconstruction, respectively.Conclusion. The use of visceral flaps in the reconstruction of the upper aerodigestive tract allows patients to restore both the nutrition and voice functions after laryngectomy.

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Şekercioğlu, Nihat, Harun Cansiz, and Muammer Güneş. "Reconstruction with composite nasal septal cartilage and auricular cartilage in extended partial laryngectomy." Journal of Laryngology & Otology 110, no. 8 (August 1996): 739–41. http://dx.doi.org/10.1017/s002221510013484x.

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AbstractSeveral reconstruction techniques have been employed following partial laryngectomy in order to improve laryngeal function. We report 12 cases in which composite nasal septal cartilage and auricular cartilage were used. We decannulated the patients in an average of 19 days. Following the reconstruction we obtained a satisfactory phonatory function and swallowing. Six patients completed a follow-up period of three years without presenting any recurrences or mortality. Our experience with reconstruction using composite nasal septal and auricular cartilage following partial laryngectomy proved effective.

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25

Klima, A., and C. V. Ilberg. "Laryngoplasty: results and problems after the creation of a neoglottis." Journal of Laryngology & Otology 102, no. 1 (January 1988): 43–44. http://dx.doi.org/10.1017/s0022215100103925.

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AbstractVoice rehabilitation in the laryngectomy patient has been a major goal of reconstructive laryngeal surgery. 36 patients underwent laryngectomy with the creation of a phonatory neoglottis as outlined by Staffieri. In 13 patients good voice rehabilitation was achieved. In 23 patients who failed to develop voice production, altered swallowing function was the major problem.

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Dong, P., X. Li, G. Wang, X. Chen, J. Xie, and T. Nakashima. "Repair with sternohyoid muscle fascia after subtotal laryngectomy." Journal of Laryngology & Otology 123, S31 (May 2009): 18–23. http://dx.doi.org/10.1017/s0022215109005039.

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AbstractBackground:The subtotal laryngectomy procedure enables the patient to avoid some of the serious consequences of total laryngectomy without having to relinquish oncological effectiveness. However, the important complication of aspiration may still seriously affect some patients. Many methods of reconstruction have been described in an attempt to avoid or minimise this complication.Methods:Thirty-nine patients (15 with supraglottic laryngeal cancer and 24 with hypopharyngeal cancer) who had undergone subtotal laryngectomy between 2000 and 2006 were included in this study. In all patients, a sternohyoid muscle flap has been used for primary, one-stage reconstruction of laryngopharyngeal defects, following resection of advanced stage lesions. Patients' times to oral intake and decannulation, their speech function and their post-operative complications were reviewed.Results:The patients' three-year overall survival rate was 46.1 per cent. Their mean time to oral intake was 14 days. Twenty-six patients were decannulated (66.7 per cent). Almost all patients regained their speech function post-operatively, although their voice quality was not as good as before surgery.Conclusions:Sternohyoid muscle fascia reconstruction leads to optimal repair of subtotal laryngectomy defects and restored laryngeal function.

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Saltagi, Mohamad Z., Chelsey A. Wallace, Avinash V. Mantravadi, and Michael W. Sim. "CO2 Laser Division of Neo-Vallecula Improves Dysphagia in the Postlaryngectomy Patient: A Case Series and Review of the Literature." Case Reports in Otolaryngology 2020 (October 19, 2020): 1–6. http://dx.doi.org/10.1155/2020/4015201.

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Objectives. To review the literature on neo-vallecula diagnosis and management and to report our findings regarding 3 patients who developed neo-vallecula in the context of free-flap pharyngeal reconstruction following total laryngectomy. Methods. This case series reports three patients who developed a neo-vallecula following a laryngectomy and free-flap pharyngeal reconstruction. All three patients were treated with a CO2 laser endoscopic procedure. Results. Neo-vallecula formation is thought to be related to tension on the neopharyngeal closure or closure technique following total laryngectomy. Diagnosis may be obtained with swallow studies, videofluoroscopy, or endoscopy. Treatment has included external excision and endoscopic procedures such as stapling, harmonic scalpel excision, and laser removal. We utilized an endoscopic approach entailing the use of a CO2 laser to divide the neo-vallecula, and all our patients reported improvement in their dysphagia. Conclusions. Treatment of an anterior neo-vallecula endoscopically using a CO2 laser is an effective way to treat dysphagia in patients following total laryngectomy with free-flap pharyngeal reconstruction.

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CALCATERRA, THOMAS C. "EPIGLOTTIC RECONSTRUCTION AFTER SUPRAGLOTTIC LARYNGECTOMY." Laryngoscope 95, no. 7 (July 1985): 786???789. http://dx.doi.org/10.1288/00005537-198507000-00007.

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Tanabe, M., I. Honjo, and N. Isshiki. "Neoglottic Reconstruction Following Total Laryngectomy." Archives of Otolaryngology - Head and Neck Surgery 111, no. 1 (January 1, 1985): 39–42. http://dx.doi.org/10.1001/archotol.1985.00800030073009.

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30

Yagudin, Ramil K., and Kamil F. Yagudin. "Reconstruction of the larynx with unipedicled sternohyoid myofascial flap following open extended vertical partial laryngectomy." International Journal of Otorhinolaryngology and Head and Neck Surgery 5, no. 1 (December 25, 2018): 231. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20185309.

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<p class="abstract">The extent of resection during open vertical partial laryngectomy may vary considerably and even an experienced surgeon may encounter difficulties in reconstructing the larynx to preserve laryngeal function and to prevent stenosis. Different local flaps were proposed for reconstruction; however, the ideal technique is still under development. A simple modification to the technique originally described by Calcaterra (1983) is presented. The unipedicled sternohyoid myofascial flap consists of the unsplit sternohyoid muscle with all three overlying fasciae harvested as a whole. The flap is rotated 90° and horizontally sutured in position to supply the necessary bulk to the entire neocord to produce a functional voice. Completely filling the mucosal defect USMF-flap allows laryngeal structures to maintain their native position and retain protective function of the larynx. The thick multilayered fascia covering facilitates rapid epithelization and prevents excessive granulation and secondary stenosis. The technique is indicated in glottic cancer patients treated by open extended vertical partial laryngectomy when the laryngeal mucosa defect is too extensive for primary closure and poses significant risk of developing postoperative stenosis.</p>

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31

Woo, Peak, and Stanley M. Shapshay. "Reconstruction of the Defect After Partial Laryngectomy." Otolaryngology–Head and Neck Surgery 112, no. 5 (May 1995): P117—P118. http://dx.doi.org/10.1016/s0194-5998(05)80295-5.

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Educational objectives: To predict the extent and type of reconstruction after partial laryngectomy based on preoperative and operative endoscopy, and to learn different techniques for reconstruction of the hemilarynx.

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32

Rifai, Mohamed. "Extended supracricoid laryngectomy with excision of both arytenoids: the modified reconstructive laryngectomy." Acta Oto-Laryngologica 127, no. 6 (January 2007): 642–50. http://dx.doi.org/10.1080/00016480601001940.

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Hanasono, Matthew M. "Use of Reconstructive Flaps Following Total Laryngectomy." JAMA Otolaryngology–Head & Neck Surgery 139, no. 11 (November 1, 2013): 1163. http://dx.doi.org/10.1001/jamaoto.2013.2768.

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34

Zhi-xiang, Guo, and Khoo Boo-Chai. "Results of reconstructive laryngectomy in 55 patients." Plastic and Reconstructive Surgery 82, no. 6 (December 1988): 1110. http://dx.doi.org/10.1097/00006534-198812000-00066.

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35

East, Charles A., A. F. Stewart Flemming, and Michael D. Brough. "Tracheostomal reconstruction using a fenestrated deltopectoral skin flap." Journal of Laryngology & Otology 102, no. 3 (March 1988): 282–83. http://dx.doi.org/10.1017/s0022215100104736.

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SummaryTracheostomal stenosis following laryngectomy can prevent satisfactor rehabilitation of a patient, and may be difficult to correct. A reconstructive technique using a flap within a deltopectoral flap to treat this condition is described.

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36

Persky, Mark S., and Angela Damiano. "Corniculate-Cuneiform Flap for Reconstruction in the Extended Vertical Partial Laryngectomy." Annals of Otology, Rhinology & Laryngology 107, no. 4 (April 1998): 297–300. http://dx.doi.org/10.1177/000348949810700407.

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The extended vertical partial laryngectomy involves removal of the vocal cord and adjacent arytenoid cartilage. Arytenoid sacrifice predisposes the patient to postoperative aspiration, since adequate laryngeal closure during swallowing cannot be accomplished. Various techniques have been previously described for reconstruction of this defect. We present five patients who had reconstruction of this area with a local, mucosally based corniculate-cuneiform flap. All patients were decannulated, had no long-term aspiration, maintained socially acceptable voice quality, and had no tumor recurrence with a minimum of 3 years of follow-up. Our preliminary data suggest that this flap can be used in previously irradiated patients. The corniculate-cuneiform flap is an effective method of reconstruction in patients undergoing an extended vertical partial laryngectomy.

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Imagawa, Norie, Keita Kishi, Katsuhiro Ishida, and Hiromi Kojima. "Voice Change Following Total Laryngectomy Reconstruction." Koutou (THE LARYNX JAPAN) 31, no. 01 (June 1, 2019): 14–18. http://dx.doi.org/10.5426/larynx.31.14.

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Chen, Hung-Chi, Yueh-Bih Tang, and Ming-Huei Chang. "Reconstruction of the Voice After Laryngectomy." Clinics in Plastic Surgery 28, no. 2 (April 2001): 389–402. http://dx.doi.org/10.1016/s0094-1298(20)32374-9.

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Tucker, Harvey M. "Near-total laryngectomy with epiglottic reconstruction." Operative Techniques in Otolaryngology-Head and Neck Surgery 1, no. 1 (March 1990): 17–20. http://dx.doi.org/10.1016/s1043-1810(10)80268-4.

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40

Burgess, Lawrence P. A. "Laryngeal Reconstruction Following Vertical Patial Laryngectomy." Laryngoscope 103, no. 3 (February 1993): 109???132. http://dx.doi.org/10.1288/00005537-199302000-00001.

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Burgess, Lawrence P. A. "Laryngeal reconstruction following vertical partial laryngectomy." Laryngoscope 103, no. 2 (February 1993): 109–32. http://dx.doi.org/10.1002/lary.5541030201.

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Emerick, Kevin S., Marc A. Herr, and Daniel G. Deschler. "Supraclavicular flap reconstruction following total laryngectomy." Laryngoscope 124, no. 8 (January 15, 2014): 1777–82. http://dx.doi.org/10.1002/lary.24530.

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43

Donnelly, Martin J., Conrad I. Timon, and Donald P. McShane. "The Role of Total Laryngectomy in the Management of Intraluminal Upper Airway Invasion by Well-Differentiated Thyroid Carcinoma." Ear, Nose & Throat Journal 73, no. 9 (September 1994): 659–62. http://dx.doi.org/10.1177/014556139407300908.

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Intraluminal invasion of the upper airway by well differentiated thyroid carcinoma is very uncommon, and the management can be problematic. Many conservative, reconstructive-type surgical procedures have been advocated to maintain normal laryngeal function. Although voice preservation is desirable, it may not always be in the patient's best interest and radical surgery, including total laryngectomy, may be necessary. We describe three cases in which total laryngectomy was performed, and review the indicators for this procedure in the treatment of this difficult to manage condition.

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Ozturk, Kerem, Serdar Akyildiz, and Ozer Makay. "Partial Laryngectomy with Cricoid Reconstruction: Thyroid Carcinoma Invading the Larynx." Case Reports in Otolaryngology 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/671902.

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Laryngotracheal invasion worsens the prognosis of thyroid cancer and the surgical approach for laryngotracheal invasion is controversial. In this paper, partial full-thickness excision of the cricoid cartilage with supracricoid laryngectomy and reconstruction of existing defect with thyroid cartilage are explained in a patient with papillary thyroid carcinoma invading the thyroid cartilage and cricoid cartilage without intraluminal invasion. Surgical indication should not be established by the site of involvement in thyroid carcinomas invading the larynx, as in primary cancers of the larynx. We think that partial laryngectomy according to the involvement site and the appropriate reconstruction techniques should be used for thyroid cancer invading the larynx.

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Laun, Jake, and Julian Pribaz. "637 Free Abdominal Tissue Transfer and Utilization of the Umbilical Stalk for “Tubular” Reconstruction in Ear, Nose and Throat Defects: A Case Series." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S174—S175. http://dx.doi.org/10.1093/jbcr/irab032.287.

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Abstract Introduction Head and neck defects, whether from burns or cancer resections, are complex and often require free flap reconstruction. Radial forearm and anterolateral thigh (ALT) flaps are commonly used due to their thin and versatile nature. However, abdominal based free tissue transfer is one valuable alternative that can cover large defects and may become a more appropriate option on the reconstructive ladder when the defect includes reconstruction of a tubular structure, such as the external auditory canal, a neck tracheostomy/stoma site or an external nasal opening. We present a novel utilization of abdominal free tissue transfer for coverage of large ear and scalp burn defects as well as neck and midface defects with usage of the umbilical stalk for tubed reconstruction. Methods Four patients presented for reconstruction: two patients had sustained large ear and scalp burns resulting in complete ear loss; one had a large neck defect resulting from recurrent cancer resection which necessitated a laryngectomy and stoma creation; and one patient had a large central face defect post-cancer resection. All four patients underwent an abdominal based free tissue transfer with reconstruction of the external auditory canal in the ear and scalp burns, stoma creation in the neck defect, and the external nasal opening in the central face defect, all utilizing the vascularized umbilical stalk for the tubed reconstruction. Results All patients recovered post-operatively without any reported complications such as tubular stenosis or contracture while maintaining umbilical stalk tubular patency. Conclusions Reconstruction of a tubed structure in head and neck defects, whether the external auditory meatus, an external nasal opening or a neck stoma post burn or cancer resection, can be a difficult and challenging operation fraught with potential complications. We present a novel method of reconstruction of large defects employing the use of the uniquely thin and vascularized umbilical stalk for tubular reconstruction.

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Zohar, Yuval. "Reconstruction of the Glottis by Composite Nasal Septal Graft." Otolaryngology–Head and Neck Surgery 112, no. 5 (May 1995): P112. http://dx.doi.org/10.1016/s0194-5998(05)80280-3.

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Educational objectives: To review the indication of partial vertical laryngectomies for carcinoma of the anterior commissure of the larynx and selected Tl of the vocal cords, and to acquire a better understanding of how to use the nasal septal graft in the glottis reconstruction.

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Lawson, Georges, Jacques Jamart, and Marc Remacle. "Improving the functional outcome of Tucker's reconstructive laryngectomy." Head & Neck 23, no. 10 (October 2001): 871–78. http://dx.doi.org/10.1002/hed.1126.

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48

Daoudi, A., A. Farhi, S.Zitouni, A. Bouchair, N. Djerad, and A. Saidia. "Les laryngectomies partielles reconstructives à propos de 55 cas." Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale 131, no. 4 (October 2014): A108—A109. http://dx.doi.org/10.1016/j.aforl.2014.07.216.

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49

Smith, Aaron, Vikrum Thimmappa, Julia Jones, Courtney Shires, and Merry Sebelik. "Use of Ultrasound for Sizing Tracheoesophageal Puncture Prostheses." Otolaryngology–Head and Neck Surgery 157, no. 6 (August 22, 2017): 1075–78. http://dx.doi.org/10.1177/0194599817722947.

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Tracheoesophageal puncture (TEP) with voice prosthesis placement is the gold standard voice rehabilitation following total laryngectomy. Ultrasound may be useful to determine tracheoesophageal wall thickness, guiding prosthesis choice. Therefore, 14 patients undergoing total laryngectomy and TEP or prosthesis change with 16-mHz ultrasound measurement of the posterior tracheal wall were included. Seven patients underwent secondary TEP, 3 primary TEP, and 4 TEP changes. Six patients underwent flap reconstruction, while 8 patients were closed primarily. Average party wall thickness was 9.6 ± 1.7 mm, without a difference ( P = .08) between primary closure (10.3 ± 1.7 mm) and flap reconstruction (8.6 ± 1.4 mm). Change from the hypothesized sizing was noted in 11 patients (79%). Prosthesis size did not correlate with age (–0.19, P = .51), height (–0.12, P = .69), weight (0.26, P = .38), body mass index (0.22, P = .46), or flap status (–0.48, P = .079). These data suggest that ultrasound is beneficial in patients with distorted or less predictable anatomy (eg, flap reconstruction) but also important for those patients undergoing primary closure.

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Allegra, Eugenia, Nicola Lombardo, Alessandro La Boria, Giuseppe Rotundo, Maria Rita Bianco, Tiziana Barrera, Manuela Cuccunato, and Aldo Garozzo. "Quality of Voice Evaluation in Patients Treated by Supracricoid Laryngectomy and Modified Supracricoid Laryngectomy." Otolaryngology–Head and Neck Surgery 145, no. 5 (July 26, 2011): 789–95. http://dx.doi.org/10.1177/0194599811416438.

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Objective. To compare quality of voice in patients treated by supracricoid laryngectomy and patients treated by modified supracricoid laryngectomy using the sternohyoid muscle for neoglottis reconstruction. Study Design. Case series. Setting. Teaching hospital. Subjects and Methods. This study was performed between 2004 and 2008 on 28 consecutive patients affected by T1b-T2 laryngeal carcinoma. Eleven patients were treated by supracricoid laryngectomy, and 17 patients were treated by modified supracricoid laryngectomy. For each patient, postoperative parameters such as decannulation time, nasogastric feeding tube, and length of hospitalization were noted. Vocal function, Voice Handicap Index scores, and perceptual voice analysis scores on intelligibility, noise, fluency, and voice scale were evaluated. Results. The postoperative course of the patients treated by modified supracricoid laryngectomy was similar to patients treated by supracricoid laryngectomy. No delay in the length of hospitalization was detected in patients undergoing surgery with the new technique. A significant difference was detected in the nasogastric tube removal time and decannulation time. The data from intelligibility, noise, fluency, and voice scale analyses revealed a better quality of voice in patients treated by modified supracricoid partial laryngectomy with a significant difference in intelligibility, fluency, and voicing. The Voice Handicap Index mean value of physical, functional, and emotional subscales confirmed patients’ perceptions of a minor voice handicap in patients treated by modified supracricoid laryngectomy, with a significant difference on the physical subscale. Conclusion. Modified supracricoid laryngectomy seems to be a good way to improve quality of voice and quality of life in patients with early laryngeal cancer.

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