Czy zszywanie zwieracza gardła dolnego po laryngektomii całkowitej jest korzystne?
Journal Title: Otolaryngologia Polska - Year 2010, Vol 64, Issue 1
Abstract
High pressure of pharyngo-esophageal segment is the most important factor of impaired development of alaryngeal speech (esophageal speech, tracheoesophageal speech) after total laryngectomy. To prevent pharyngo-esophageal spasm in Department of Otolaryngology in Szczecin are used: pharyngoesophageal plastic surgery with interposition of vascular thyroid fl ap, two-layer (only mucosa) non-muscular pharyngeal closure and tree-layer closure (mucosa and muscle layer leaving inferior pharyngeal constrictor unsutured). Aim of study: The aim of this study was to compare the pharyngo-esophageal pressure between patients after pharyngo-esophageal plastic surgery and following the non-muscular pharyngeal closure. Material and methods: One hundred eighty two subjects after total laryngectomy were enrolled in this study, and included 108 patients subjected to the pharyngo-esophageal plastic surgery, 44 patients who underwent the two-layer pharyngeal closure, and 30 patients with the tree-layer closure. To evaluate the pharyngo-esophageal pressures manometric tests were performed, and to asses the pharynx morphology videopharyngoscopy was used. Results: The average pharyngo-esophageal pressure in the group after the pharyngo-esophageal plastic surgery was 32 (min.-5, max. 50) mmHg. After the two-layer non-muscular pharyngeal closure mean pressure was 35 (min.-17, max.-40) mmHg, and after the tree-layer non-muscular pharyngeal closure the average pressure was 22,42 (min. 5, max. 40) mmHg. The average pharyngo-esophageal pressure was signifi cantly lower (p<0,01) among patients after the tree-layer non-muscular closure. Conclusion: The study suggests that the tree-layer non-muscular pharyngeal closure with inferior pharyngeal constrictor unsutured is the preferable method to prevent pharyngo-esophageal spasm after total laryngectomy. However, the effi cacy and safety of this surgical procedure should be explored in further multicenter studies.
Authors and Affiliations
Czesława Tarnowska, Ewa Grochowska-Bohatyrewicz, Stanisław Bień, Jarosław Sieczka, Jakub Lubiński
Keywords
Related Articles
- EP ID EP51900
- DOI -
- Views 118
- Downloads 0
Paratracheal lymph nodes in patients with larynx and hypopharynx cancer in radiological and clinical examination
Introduction. Paratracheal lymph nodes receive the lymph from the larynx, hypopharynx, esophagus, thyroid gland and trachea. It is evaluated, that metastases to these nodes occur in about 10–30% of patients with cancer o...
Consenting Practice of ENT Trainees: To What Extent Is Trainee Involvement Disclosed?
Aim – To assess to what extent ENT trainees disclose their involvement in operations to their patients when obtaining consent.Background – It is not clear how the trainees are conducting the consenting process, although...
The effects of cochleostomy of hearing threshold in animal experiment
SUMMARY Introduction: To assess an effect of cochleostomy on hearing threshold in guinea pigs. Material and methods: The authors performed animal experiments using fi ve 3-month-old guinea pigs. Before experiment hearing...
Ocena wyników leczenia zawrotów głowy pochodzenia szyjnego za pomocą kinezyterapii – doniesienie wstępne
Introduction: The work aimed at analyzing results of kinesitherapeutic procedures in patients with cervical vertigo as well as evaluating a mobility range of the cervical spine. Material and methods: The study was conduc...
Sprawozdanie z IV Międzynarodowej Konferencji