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 106
- Downloads 0
Endoscopic sinus balloon catherisation – evolution or revolution in treatment of rhinosinusitis? Our experience and literature review
Sinus ostium patency is a key point in treatment of rhinosinusitis. Thanks to minimally invasive set of tools dilation of ostium without tissue removal is possible that was demonstrated in large multicenter studies. The...
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...
Epidemiologia raka krtani i gardła dolnego w latach 1988–2012 w materiale Kliniki Otolaryngologii Uniwersytetu Medycznego w Białymstoku
Malignant tumour is the second cause of death in Poland, behind cardiovascular disease. 26% of men and 23% of women die of it. Head and neck tumours are the fi fth most frequent group of malignant tumours. These are most...
Rynometria optyczna – nowe wyzwania i nowe możliwości diagnostyki rynoalergologicznej
Rynometria optyczna – jako jedyne narzędzie wykorzystywane w diagnostyce rynoalergologicznej – ocenia zmiany drożności nosa rejestrowane w czasie rzeczywistym. Jest więc swoistą odpowiedzią na zmiany toczące się w świetl...
Chirurgia endoskopowa zatok przynosowych i podstawy czaszki ze wspomaganiem neuronawigacją: porównanie systemów optycznych i elektromagnetycznych
Transnasal endoscopic operative methods became increasingly popular in paranasal sinuses and cranial base surgery. Various types of localization systems are recently used to navigate through and between tangled anatomica...