Abstract | UNLABELLED: High pressure of pharyngo-esophageal segment is the most important factor of impaired development of alaryngeal speech ( esophageal speech, tracheoesophageal speech) after total laryngectomy. To prevent pharyngo- esophageal spasm in Department of Otolaryngology in Szczecin are used: pharyngoesophageal plastic surgery with interposition of vascular thyroid flap, two-layer (only mucosa) non-muscular pharyngeal closure and tree-layer closure (mucosa and muscle layer leaving inferior pharyngeal constrictor unsutured). AIM OF STUDY: The aim of this study was to compare the pharyngo-esophageal pressure between patients after pharyngo-esophageal plastic surgery and following the non-muscular pharyngeal closure. MATERIAL AND METHODS: One hundred eighty two subjects after total laryngectomy were enrolled in this study, and included 108 patients subjected to the pharyngo-esophageal plastic surgery, 44 patients who underwent the two-layer pharyngeal closure, and 30 patients with the tree-layer closure. To evaluate the pharyngo-esophageal pressures manometric tests were performed, and to asses the pharynx morphology videopharyngoscopy was used. RESULTS: The average pharyngo-esophageal pressure in the group after the pharyngo-esophageal plastic surgery was 32 (min.-5, max. 50) mmHg. After the two-layer non-muscular pharyngeal closure mean pressure was 35 (min.-17, max.-40) mmHg, and after the tree-layer non-muscular pharyngeal closure the average pressure was 22,42 (min. 5, max. 40) mmHg. The average pharyngo-esophageal pressure was significantly lower (p < 0.01) among patients after the tree-layer non-muscular closure. CONCLUSION: The study suggests that the tree-layer non-muscular pharyngeal closure with inferior pharyngeal constrictor unsutured is the preferable method to prevent pharyngo- esophageal spasm after total laryngectomy. However, the efficacy and safety of this surgical procedure should be explored in further multicenter studies.
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Authors | Czesława Tarnowska, Ewa Grochowska-Bohatyrewicz, Stanislaw Bień, Jarosław Sieczka, Ewa Jaworowska, Jakub Lubiński |
Journal | Otolaryngologia polska = The Polish otolaryngology
(Otolaryngol Pol)
2010 Jan-Feb
Vol. 64
Issue 1
Pg. 37-42
ISSN: 0030-6657 [Print] Poland |
Vernacular Title | Czy zszywanie zwieracza gardła dolnego po laryngektomii całkowitej jest korzystne? |
PMID | 20476591
(Publication Type: Comparative Study, English Abstract, Journal Article)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Squamous Cell
(surgery)
- Esophageal Spasm, Diffuse
(prevention & control, surgery)
- Female
- Humans
- Laryngeal Neoplasms
(surgery)
- Laryngectomy
(methods)
- Male
- Middle Aged
- Pharyngeal Muscles
(surgery)
- Postoperative Care
(methods)
- Pressure
- Speech, Esophageal
(methods)
- Surgical Flaps
- Voice Disorders
(etiology)
- Voice Quality
- Voice Training
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