Present and Future in Voice Reconstruction After Laryngectomy

Abstract

Since 1976 we have been performing the tracheoesophageal (TE) fistulization for voice reconstruction after total laryngectomy. Out of 341 patients who underwent the TE fistulization, 276 (81%) had voice capability with TE phonation. Of 276 TE speakers, 201 underwent TE fistulization with sphincter mechanism against aspiration using bilateral esophageal muscle flaps. One hundred and seventy eight (89%) of these 201 TE speakers could swallow without aspiration problem. Over the past 10 years, a total of 24 patients underwent the tracheojej unal (TJ) f istulization for voice reconstruction after pharyngolaryngoesophagectomy with free jejunum reconstruction. Nineteen (79%) of 24 patients retained voice capability with TJ phonation. As far as swallowing function is concerned, eighteen (95%) of 19 TJ speakers could swallow without aspiration problem.