抄録
We developed a new method of surgical reconstruction of the cervical esophagus after laryngopharyngoesophagectomy with free ileocecal grafting. In this technique we reconstructed the esophagus using the colic segment, while a phonatory shunt is fashioned from the terminal ileum. The ileocecal valve functions not only as an anti-reflux valve against aspiration but also as a pseudo-glottis. We evaluated functions of the ileocecal valve both experimentally and clinically as a source of vocalization. Experimental studies showed that the average frequency of phonation with the ileocecal valve ranges 122-197 Hz in dog series and 89-104 Hz in monkey series, and that the driving pressure during phonation varied 18-52 mmHg in the former series and 10-14 mmHg in the latter. These driving pressures did not exceed those of healthy people during easy phonation. Out of the 6 patients undergoing this operation, three are alive at the time of this writing. All of them aquired fair to good shunt voice without marked aspiration. We conclude that our procedure can be used as a new surgical method of voice restoration after laryngopharyngoesophagectomy.
