| Results of vocal rehabilitation using tracheoesophageal voice prosthesis after total laryngectomy and their predictive factors. | |
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MedLine Citation:
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PMID: 19890656 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aims of this retrospective study were to evaluate prosthetic voice restoration by tracheoesophageal puncture (TEP) in laryngectomized patients and to identify clinical factors correlated with functional outcomes. Between 2000 and 2008, 103 patients who underwent total laryngectomy or pharyngolaryngectomy (TPL) were included in our study. Functional outcomes were recorded 6 months postoperatively, and results were scored from 0 to 2 for oral diet and speech intelligibility. Lifetime of voice prosthesis and early and late complications were recorded. The impact of several clinical factors on functional outcomes, prosthetic valve lifetime and complications was assessed in univariate analysis. A total of 87 patients (84%) underwent TEP and speech valve placement (79 primary and 8 secondary punctures). Hypopharyngeal tumors (P = 0.005), circular TPL (P = 0.003) and use of a pectoralis major myocutaneous flap (P = 0.0003) were significantly associated with secondary TEP. Successful voice rehabilitation was obtained by 77 of 82 evaluable patients (82%). A high level of comorbidity (ASA score > or = 3; P = 0.003) was correlated to speech rehabilitation failure. The median device lifetimes were 7.6 and 3.7 months for Provox I and II speech valves, respectively. Minor leakage around the valve occurred in 26% of the patients. Late complications occurred in 14 patients (16%) including: severe enlargement of the fistula (n = 3), prosthesis displacement (n = 7) and granulation tissue-formation (n = 4). In conclusion the use of voice prosthesis showed a high success rate of vocal rehabilitation with an acceptable complication rate. |
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Authors:
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Alexandre Bozec; Gilles Poissonnet; Emmanuel Chamorey; François Demard; José Santini; Frédéric Peyrade; Cécile Ortholan; Karen Benezery; Juliette Thariat; Anne Sudaka; Katia Anselme; Brigitte Adrey; Paul Giacchero; Olivier Dassonville |
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Publication Detail:
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Type: Journal Article Date: 2009-11-05 |
Journal Detail:
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Title: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery Volume: 267 ISSN: 1434-4726 ISO Abbreviation: Eur Arch Otorhinolaryngol Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-03-24 Completed Date: 2010-08-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9002937 Medline TA: Eur Arch Otorhinolaryngol Country: Germany |
Other Details:
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Languages: eng Pagination: 751-8 Citation Subset: IM |
Affiliation:
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Département de Chirurgie, Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06189 Nice, France. alexandre.bozec@nice.fnclcc.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Dysphonia / diagnosis*, therapy* Female Humans Laryngectomy / methods* Larynx, Artificial* Male Middle Aged Pharyngectomy / methods Predictive Value of Tests Retrospective Studies Severity of Illness Index Tracheoesophageal Fistula* Voice Quality Voice Training* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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