Abstract
Loss of voice often results from removal of the laryngo-trachea and pharyngo-esophagus in patients with cervical esophageal or hypopharyngeal cancer. A new voice reconstruction method (the double T. E. G. shunt) for laryngectomized, pharyngo-esophagectomized patients was devised by the author.
A gastric tube with a lower esophago-cardiac loop (6-7cm long) is mobilized up to the neck with good blood supply from the right gastric and gastro-epiploic artery. A stenosis (2.5cm long) is formed in the esophagus near the cardia. A double tracheo-esophago-gastric shunt is created by anastomosis between the trachea and the distal end of the esophagus.
This new method makes high-quality and high-efficiency phonation possible. Physiological studies on these voices have revealed a normal intensity in spite of a low air-flow rate. Sound spectrography has characteristically indicated intermittent sounds with a little noise. The patients could speak well. Recovery of phonation using the esophago-cardiac loop thus seems to be a promising prospect for laryngectomized patients with cervical esophageal or hypopharyngeal cancer using the double T. E. G. shunt method.
