Abstract
We devised a new surgical method using a free ileocecal patch graft for voice restoration after laryngectomy. The terminal ileum and cecum were removed through a pararectus incision. The cecum was cut in the form of a patch, which size was equalized with that of the hypopharyngeal defect, while paying attention not to injure the Bauhin valve. The graft was transferred to the neck, and the feeding pedicle of the graft was anastomosed to cervical vessels, with microvascular surgery. The hypopharyngeal defect was repaired by a free ileocecal patch, and phonation was completed by a tracheo-ileocecal shunt. This method has been applied to 3 cases of laryngeal cancer, 2 of thyroid cancer, and one of tongue cancer. All patients, except one who died an the 28th postoperative day due to rupture of a carotid artery, were able to speak and swallow without aspiration. The advantages of this method are listed: (1) operational procedure is not complicated and could be performed even for the first time by one surgeon using this procedure, (2) because hypopharyngeal defect has repaired by ileocecal patch, it does not become narrowed and the passage of food is also good, (3) phonation can be facilitated soon after surgery, and (4) even in a patient who received a total laryngectomy in the past, voice restoration, is possible by receiving this new procedure.
