Studies on treacheostomal formation and voice prosthesis after total laryngectomy

WU Hong, YU Youjun, CHEN Weixiong, et al. Department of Otorhinolaryngology, Foshan First People's Hospital, Guangdong 528000  

Objective To establish a tracheostomy model with no stricture and “bowl shaped” collapse. Methods Twenty five cases were reconstructed with Blom Singer technique after total laryngectomy for tracheoesophageal voice in our department since 1996. Tracheostoma was done with 5 kinds of methods. In 6 cases ,anterior cervical U shaped incision + division of sternal attachments of bilateral sternomastoid muscles + Griffith tracheostoma enlargement (combination method ) were used in the primary operation, and the third generation of indwelling prosthesis and tracheostomal valve were installed. Results In these 25 cases, 23 could speak freely. The successful rate was 92%. In tracheostoma operation, there were 7 cases with their skin sutured directly to tracheal rings, 3 cases with Myers method, 6 cases with Griffith method, 3 cases with method. All of them needed cannulation for more than 6 months and had stricture of tracheostoma and “ bowl shaped” collapse of various degrees. But those underwent “combination method” needed no cannulation and no stricture and bowl shaped collapse was found during 6 mouths’ follow up. Conclusion The combination method of tracheostomy makes the installation, postoperative care and replacement of prosthesis and tracheostomal valve easy and the indwelling prosthesis has the best tone quality. The use of tracheostomal valve effectively makes the patient's hand free during speaking.

【Key Words】： Larynx artificial Speech alaryngeal Laryngectomy Tracheostoma enlargement
【CateGory Index】： R767.92
【DOI】： cnki:ISSN:0412-3948.0.1999-01-019

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