Arytenoid vocal shunt in laryngectomized patients

Abstract

A method is presented for forming short, mucosa-lined vocal shunt in cases of supracricoid laryngectomy with preservation of one or two arytenoids, or the interarytenoid fold alone. On the basis of radiologic and particularly radiocinematographic examinationion of the anterior pharyngeal wall is of paramount importance. In cases of complete absence of leakage, said wall lies in the plane of the arytenoids or somewhat posteriorly. After simple supracricoid laryngectomy it is possible to prevent aspiration also by translocation of the anterior pharyngeal wall into the plane of the cricoid cartilage plate. The clinical experience with this supracricoid shunt is still scanty. Of 25 cases with the arytenoid vocal shunt, phonation was possible in 22 cases under the expiratory pressure of 20-45 cm H2O; in one under the more elevated pressure, and in the last two the result is still not known. Loudness of speech was 70-100 db and its comprehensibility 73-90 percent. Complete absence of leakage was observed in 17 cases, "practical" prevention of aspiration (some drops of thin fluids, no saliva) in seven cases, profuse leakage in one case (ceased after correction), In the last 10 consecutive cases the problem of aspiration was completely eliminated. Advantages and disadvantages of our own method in comparison with Asai's method have been presented.

History of Voice Rehabilitation Following Laryngectomy

“…This allowed good protection against aspiration and needed only low pressure to open the fistula on expiration. The satisfactory preliminary results were published in The Laryngoscope , 40 but were not mentioned by Pearson in his later publications.…”

A short history of laryngeal cancer surgery worldwide and in Turkey: our experiences

“…Mozolewski ve ark. [79] 1975'de her iki aritenoidin korunduğu interaritenoid şant ile ilk dinamik şant tekniğini uygulamıştır. Pearson, [80][81][82] 1980'de dinamik şantı tek aritenoidle gerçekleştirmiş ve tekniği önce genişletilmiş hemilarenjektomi, sonra subtotal larenjektomi olarak adlandırmıştır.…”

Μαλπιγγιακός Καρκίνος Κεφαλής Και Τραχήλου

“…Άλλοι ερευνητές αναφέρουν σημαντική εισρόφηση 207 . Ο Mozalewski και οι συνεργάτες του δημιούργησαν αρυταινοειδείς παράκαμψεις χρησιμοποιώντας τους αρυταινοειδείς και ευκίνητα τμήματα βλεννογόνου από το φαρυγγικό τοίχωμα 208 . Οι Weisberger και Linngeman χρησιμοποίησαν τη μέθοδο αυτή για να διατηρήσουν την ομιλία μετά από ολική γλωσσεκτομή 209 .…”