Surgical rehabilitation of voice function after laryngectomy

Restoring voice function is an important aspect of rehabilitation for patients with stage III and IV laryngeal cancer following total larynx removal. Good functional results can be achieved with various types of shunting surgeries, with the quality of restored speech being quite high. The combination of tracheoesophageal shunting and voice prosthetics expands the rehabilitation options for patients after laryngectomy. This is the conclusion reached by doctors at the ENT Clinic of the Donetsk Institute of Vocal Surgery. Between 2000 and 2005, they... In 197 patients with stage III-IV laryngeal cancer, laryngectomy was performed with one of the types of voice restoration surgery: one-stage tracheopharyngeal or tracheoesophageal mucosal shunting - in 114 (57.87%), delayed tracheoesophageal shunting - in 52 (26.39%), and tracheoesophageal shunting with prosthetics - in 31 (15.74%). The operation was performed on male patients with laryngeal cancer aged from 42 to 69 years, with a histologically verified diagnosis. Of these, the lesion volume in 108 patients corresponded to stage T3N0M0, in 51 - T4N0M0, in 38 - T4N1M0. In addition to laryngectomy, the following were performed in 38 patients with stage T4N1M0 disease: Krail operation (24), case-fascial excision of the lateral neck tissue (14 patients). All patients underwent one of the types of surgery to restore voice function. The choice of the type of voice restoration surgery depended on the localization of the tumor process in the larynx and the degree of its spread to the laryngopharynx, the retrocricoid space, and the trachea. Surgical interventions on the routes of metastasis were not contraindications to voice restoration surgeries.