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 123
- Downloads 0
Comparison of the incidence rates of coincident symptoms in a group of patients with Vertigo
ÚVOD: Závrať je druhým nejčastějším příznakem. kvůli kterému pacienti musí vyhledat lékaře. Efektivní léčba závrativých stavů vyžaduje spolupráci mnoha lékařských odvětní. CÍL: Cílem bylo analyzovat údaje z databáze pac...
Usuwanie zmian chorobowych w obrębie narządów ORL w pracowni laserowej Kliniki ORL Oddziału Stomatologii w Warszawie w roku 2005
Introduction: For 13 years now we use neodine – laser in our clinic. In 2005 we treated 463 patients using this laser with local anesthesia. There are 47 cases presented in article (28 women and 19 men) from who pieces o...
Combined tumor of ceruminous gland origin in the external auditory canal — a histopathological and immunohistochemical study
SUMMARY Objectives: We present a case of a combined tumor consisting of solid tubular gland adenoma (TA) and syringocystadenoma papilliferum (SCAP) of the external auditory canal and review of the literature on this subj...
The predictive value of videostroboscopy in the assessment of premalignant lesions and early glottis cancers
Objective: To assess the sensitivity and specificity of larngovideostroboscopy (LVS) in the diagnosis of precancerous and malignant lesions of the vocal folds. Material and methods: In 175 patients (128 men and 47 women)...
Comparison of different deafening strategies based on ototoxic drugs on mouse animals model
SUMMARY Aim of the study: To compare safety, reliability and usefulness of two deafening protocols on animal mouse model, based on aminoglycosides exposure Material and method: Adults mice, Bulb/C, deafened with kanamyci...