gms | German Medical Science

Introduction: Among the various surgical methods of voice rehabilitation after total laryngectomy Hagen's surgical procedure appears to be the most promising one. Here we report our clinical experience with this procedure during the last ten years.

Patients and methods: In 28 patients we reconstructed a stable tracheo-oesophageal voice shunt by a microvascular radial forearm flap according to Hagen. The specifics of this surgical method is the forming of a cartilage-consolidated neoepiglottis as well as the dynamic ventil mechanism due to the suspension of the substitute larynx tube above the hyoid bone.

Results: Operation procedure was successful in 27 patients (96%). These patients learned to speak before being released from the hospital. Transplant failure occurred in one patient. Inconsistent low volume aspiration was still present in 3 patients a few months after operation without the need of surgical revision. Recanalisation of a stenosis at the pharyngeal end of the laryngoplasty due to scar formation was successfully performed in one patient.

Conclusion: Hagen's laryngoplasty allows a care-free and reliable rehabilitation of voice function preserving almost aspiration free swallowing. Therefore this time and resource consuming technique along with high operation risks proves to be a well suited and practicable procedure when indicated. Its economic benefit becomes more obvious when applied to younger patients compared to the use of voice prosthesis.