2019 Volume 45 Issue 3 Pages 318-322
Esophageal speech, electrolarynx, and tracheoesophageal shunt with prosthesis are the most common methods of rehabilitation after total laryngectomy. The Amatsu tracheoesophageal shunt operation reduces the risk of aspiration and the rehabilitated voice has a good quality and does not require additional costs for its maintenance. It is one of the ideal ways of producing sound.
In 1996, the Amatsu tracheoesophageal shunt was reported by the Oto-Rhino-Laryngological Society of Japan. However, it has not yet spread much except at some facilities.
Between 2015 to 2017, 7 patients received the Amatsu method after total laryngectomy in the Shizuoka Cancer Center (Mishima, Shizuoka, Japan). Six were able to speak intelligibly, requiring a median time of 10 months.
The time to starting speech training was 26-40 postoperative days (median: 29 days). The date when the audio was confirmed was 33-64 days (median: 53 days). There were no cases with aspiration from the bronchesophageal shunt and the phonation time was 7-27 seconds (median: 22 seconds).
It seems that postoperative management including ventilation and bougie is necessary for the patient to acquire voice.