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赵 小, 马 志, 李 碧, 冯 勇, 余 晓, 樊 建, 何 刚, 李 彬. [The one-stage technology of epiglottis function and voice reconstruction after total laryngectomy with the sternohyoid myocutaneous flap]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 36:753-757. [PMID: 36217653 PMCID: PMC10128554 DOI: 10.13201/j.issn.2096-7993.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Indexed: 06/16/2023]
Abstract
Objective:To investigate the clinical effect of one-stage sternohyoid musculocutaneous flap after total laryngectomy for reconstruction of epiglottis function and vocalization. Methods:A retrospective analysis of 8 patients who underwent total laryngectomy from November 2019 to September 2020. The sternohyoid myocutaneous flap was designed after total laryngectomy. The lower edge of the flap was sewed with the posterior upper edge of the tracheostomy opening, and the lateral and medial edges of the flap were anastomosed to create a vocal tube. The lateral edge of the upper end of tube was sutured with the anterolateral wall of the hypopharynx, then made full use of residual epiglottis and tongue root tissue to reconstruct epiglottis function. Results:None of the 8 patients had serious complications after total laryngectomies. Fifteen months after operation,the vocal tube flaps survived and had intact structure under fiberoptic laryngoscope. All patients could speak clearly and forcefully, and the swallowing function was intact. Conclusion:The use of adjacent myocutaneous flap to construct the vocal canal and reconstruct the epiglottis function is a simple and effective technique that can be completed in one stage and improve the voicing of patients undergoing total laryngectomy.
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Affiliation(s)
- 小龙 赵
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都，610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 志跃 马
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都，610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 碧澜 李
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都，610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 勇 冯
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都，610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 晓旭 余
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都，610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 建刚 樊
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都，610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 刚 何
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都，610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 彬 李
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都，610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
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Abstract
This article reviews methods of voice reconstruction. Nonsurgical methods of voice reconstruction include electrolarynx, pneumatic artificial larynx, and esophageal speech. Surgical methods of voice reconstruction include neoglottis, tracheoesophageal puncture, and prosthesis. Tracheoesophageal puncture can be performed in patients with pedicled flaps such as colon interposition, jejunum, or gastric pull-up or in free flaps such as perforator flaps, jejunum, and colon flaps. Other flaps for voice reconstruction include the ileocolon flap and jejunum. Laryngeal transplantation is also reviewed.
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Affiliation(s)
- Hung-Chi Chen
- Department of Plastic Surgery, E-Da Hospital/I-Shou University, Jiau-shu Tsuen, Yan-chau Shiang, Kaohsiung County, Taiwan
| | - Karen F. Kim Evans
- Georgetown University Medical Center, Veterans Affairs Medical Center, Washington, District of Columbia
| | | | - Samir Mardini
- Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
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