Rehabilitation Program for Prosthetic Tracheojejunal Voice Production and Swallowing Function Following Circumferential Pharyngolaryngectomy and Neopharyngeal Reconstruction with a Jejunal Free Flap

Baijens, Laura W. J.; Speyer, Renée; Roodenburg, Nel; Hilgers, Frans J. M.

doi:10.1007/s00455-010-9279-z

Cited by 5 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several studies have reported on the use of prosthetics for voice restoration following TPL . However, most of these were small case series or included various reconstruction methods.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have reported on the use of prosthetics for voice restoration following TPL. 6,7,[9][10][11] However, most of these were small case series or included various reconstruction methods. Therefore, the features and complications of an indwelling voice prosthesis in patients who undergo TPL with free jejunal reconstruction have not been established in large cohorts.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

Fukushima

Kanazawa

Kawabata

et al. 2017

Laryngoscope Investig Oto

View full text Add to dashboard Cite

ObjectivesTotal pharyngolaryngectomy with free jejunal reconstruction is often performed in patients with hypopharyngeal carcinoma. However, postoperative speechlessness significantly decreases patient quality of life. We investigated whether Provox® insertion could preserve speech after total pharyngolaryngectomy with free jejunal reconstruction.Study DesignRetrospective chart review.MethodsA total of 130 cases of secondary Provox® insertions after total pharyngolaryngectomy with free jejunal reconstruction were analyzed. Communication outcomes were compared using the Head and Neck Cancer Understandability of Speech Subscale. Outcomes and complications associated with insertion site (jejunal insertion vs. esophageal insertion) and adjuvant irradiation therapy were also evaluated.ResultsProvox® insertion had favorable communication outcomes in 102 cases (78.4%). Neither the insertion site nor irradiation affected the communication outcome. Complications were observed in 20 cases (15.4%). Local infection was the most common complication. Free jejunal insertion, in which the resection range was enlarged, had a lower complication rate than did esophageal insertion, and its complication rate was unaffected by previous irradiation. For all patients, the hospitalization duration and duration of speechlessness were 13.4 days and 14.6 months, respectively. Patients receiving jejunal insertions had a significantly shorter hospitalization duration than did those receiving esophageal insertions. Unlike Provox®2, Provox®Vega significantly reduced the complication rate to zero.ConclusionFor jejunal inserson of a Provox® prosthetic, a sufficient margin can be maintained during total pharyngolaryngectomy and irradiation can be performed, and satisfactory communication outcomes were observed. Provox® insertion after total pharyngolaryngectomy with free jejunal reconstruction should be considered the standard therapy for voice restoration.Level of Evidence4.

show abstract

“…Several studies have reported on the use of prosthetics for voice restoration following TPL . However, most of these were small case series or included various reconstruction methods.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

Fukushima

Kanazawa

Kawabata

et al. 2017

Laryngoscope Investig Oto

View full text Add to dashboard Cite

show abstract

“…No specific swallowing rehabilitation programmes for laryngectomized patients have been described yet, and based on careful VF-evaluation, swallowing exercises by the SLP often have to be individualized. 9 Smell/taste rehabilitation Loss of (passive) sense of smell is yet another obvious consequence of the disconnection of the upper and lower respiratory tracts, and the relevance of olfaction for taste is well known. Tracheostoma breathing precludes passage of breathing air along nasal olfactory epithelium and thus of 'registration' of odour molecules, essential for normal passive sense of smell.…”

Section: Dysphagia Rehabilitationmentioning

confidence: 99%

Practice of laryngectomy rehabilitation interventions

Molen

Kornman

Latenstein

et al. 2013

Current Opinion in Otolaryngology & Head and Neck Surgery

View full text Add to dashboard Cite

General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. 2 AbstractPurpose of Review Total laryngectomy rehabilitation (TLR) in Europe is not uniform, with quite some differences in approach and infrastructure between the various countries. In e.g. the Netherlands, Switzerland, Scandinavia, and more recently also in the UK, Head and Neck Cancer treatment and rehabilitation shows a high level of centralisation in dedicated HNC centres. In other European countries, the level of centralisation is lower, with more patients treated in lowvolume hospitals. This paper focuses on the situation in the Netherlands, and where applicable, will discuss regional variations in Europe.Recent Findings Prosthetic surgical voice restoration (PSVR) presently is method of choice in Europe, and use of oesophageal and electrolarynx voice has moved to the background. In most European countries (except UK and Ireland), PSVR is physician driven, with an indispensable role for Speech Language Pathologists, and increasingly for oncology nurses. Indwelling voice prostheses are mostly preferred, also because these devices can be implanted at the time of tracheaoesophageal puncture. Pulmonary rehabilitation is achieved with heat and moisture exchangers, which, based on extensive clinical and basic physiology research, are considered an obligatory therapy measure. Besides PSVR, also issues such as smoking cessation, dysphagia/swallowing rehabilitation, and olfaction/taste rehabilitation are discussed. Especially the latter has shown great progress over the last decade, and is another example of increasing implementation of evidence-based practice in TLR.Summary TLR has shown considerable progress over the last decades, and through the intensified collaboration between all clinicians involved, significantly has improved vocal, pulmonary, and olfactory rehabilitation after TL. KeywordsTotal laryngectomy; voice rehabilitation; pulmonary rehabilitation; olfactory rehabilitation; swallowing rehabilitation; multidisciplinary approach Bullet list  Prosthetic Surgical Voice Restoration is the method of choice for re-establishing postlaryngectomy oral communication, ensuring early regain of optimal voice and speech quality  As with any surgical method, adverse events have to be taken into account, but clinica...

show abstract

Free jejunum reconstruction of upper esophageal defects

et al. 2012

View full text Add to dashboard Cite

The free jejunum has become an important method for reconstructing extensive oncologic defects of the upper esophagus and pharynx. The advantages of a single-staged reconstruction with a low incidence of morbidity have generally outweighed criticisms such as the requirement for a laparotomy and poor voice quality. The aim of the study was to present the technique and outcomes of free jejunal reconstruction of the upper esophagus in 31 consecutive cases. We reviewed our experience of free jejunal flaps undertaken over a 6-year period. Our surgical approach, complications, and results of swallow and speech restoration are described. A functional swallow was achieved by 27/31 patients. However, satisfactory voice restoration was seen in only a small proportion of patients. Complications at the donor site occurred in just one patient. The current review confirms the jejunal flap as a reliable reconstructive option with minimal donor site morbidity.

show abstract

Rehabilitation Program for Prosthetic Tracheojejunal Voice Production and Swallowing Function Following Circumferential Pharyngolaryngectomy and Neopharyngeal Reconstruction with a Jejunal Free Flap

Cited by 5 publications

References 11 publications

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

Practice of laryngectomy rehabilitation interventions

Free jejunum reconstruction of upper esophageal defects

Contact Info

Product

Resources

About