Voice restoration by primary insertion of indwelling voice prosthesis following circumferential pharyngolaryngectomy with free jejunal graft

Pharyngolaryngectomy with free jejunal autograft reconstruction and tracheoesophageal voice restoration: Indications for replacements, microbial colonization, and indwelling times of the Provox 2 voice prostheses

“…3,[13][14][15][16][17] Recent studies focus on functional speech outcomes and quality of life after voice restoration with voice prostheses after laryngectomy and after pharyngolaryngectomy. 6,[18][19][20] McAuliffe et al 18 evaluated the quality of tracheoesophageal voice in 13 patients who underwent a pharyngolaryngectomy with jejunal free flap reconstruction in comparison to 30 patients after laryngectomy. Patients with jejunal autografts showed significantly less pleasant voice results with reduced levels of speech intelligibility and higher personal disability ratings.…”

“…In 2001, Benazzo et al 6 demonstrated that patients after jejunal autograft reconstruction were able to produce satisfying tracheoesophageal speech for daily communication using the Provox 2 voice prostheses. In 2005, Furuta et al 19 published a case series of patients with free jejunal reconstruction using the Groningen voice prostheses. Excellent speech intelligibility and tracheoesophageal speech quality was achieved in 6 of 8 patients and moderate voice quality in 2 of 8 patients.…”

Free jejunal graft reconstruction after resection of neck cancers: Our surgical technique

“…The tracheoesophageal shunt and the "elephant trunk" shunt have been used to recover the function of speech. 23,24 Furuta et al 23 reported that six of eight patients who received a tracheoesophageal shunt achieved excellent speech intelligibility. Conversely, the speech outcome achieved by a tracheoesophageal shunt is occasionally insuffi cient: according to another report, patients receiving a tracheoesophageal shunt frequently fell into aphony.…”

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

“…Tracheoesophageal puncture and insertion of a voice prosthesis has become the standard treatment protocol for voice restoration [1, 2]. Most frequently, a secondary voice restoration is performed several months following surgery [3]. Probably the jejunal convolutions and hypotonicity are major reasons leading to disordered prosthetic tracheojejunal voice production [4].…”

“…Stenosis of the jejunoesophageal anastomosis, absence of a functional muscular layer in the jejunal graft, and the major difference in diameter between the jejunal graft and the cervical esophagus are important causal factors of dysphagia. Futura et al [3] suggest that placement of the voice prosthesis close to the jejunoesophageal anastomosis may cause scar formation resulting in deterioration of the prosthetic tracheojejunal voice production and swallowing function. In the literature, most of the studies handling prosthetic tracheojejunal voice production or swallowing function following circumferential pharyngolaryngectomy with free jejunal flap repair include rather small patient populations or do not report diagnostic imaging assessments or therapy programs for swallowing disorders or speech disorders [6, 7].…”