Artikel
Prosthetic voice rehabilitation after laryngectomy - complications after initial radiation
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Autoren
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Frank Rosanowski
- Dpt. Phoniatrics and Pedaudiology, Erlangen University Hospital, Erlangen
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Maria Schuster
- Dpt. Phoniatrics and Pedaudiology, Erlangen University Hospital, Erlangen
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Ulrich Eysholdt
- Dpt. Phoniatrics and Pedaudiology, Erlangen University Hospital, Erlangen
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Peter Kummer
- Dpt. Phoniatrics and Pedaudiology, Erlangen University Hospital, Erlangen
| Veröffentlicht: | 22. September 2005 |
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Gliederung
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Background: Indwelling voice prosthesis proved to be state-of-the-art of postlaryngectomy voice rehabilitation. The aim of this study was to identify the impact of radiation prior to tracheoesophageal puncture on success rate and complications. Patients and methods: We undertook a retrospective study of 145 patients who had undergone prosthetic voice restoration between 1990 and 2002 (Provox® and Provox2®). Risks of functional failure and complications of 17 patients with previous radiation were compared to those of 128 patients without previous radiation.
Results: Previous radiation increased not only the risk of functional failure by 2.9 (p=0.023), but also the risk of shunt-related complications such as aspiration around the prosthesis (1.51; p=0.046), widening of the shunt (2.32; p=0.014), esophageal (2.51; p=0.013) or tracheal (3.29; p=0.0023) dislocation of the prosthesis and spontaneous (2.51; p=0.047) or surgical closure (3.76; p=0.037) of the shunt.
Conclusion: Primary tracheoesophageal puncture during laryngectomy is recommended in cases without previous radiation, especially when postlaryngectomy radiation is likely. In patients with previous radiation, generally good success rates decrease, however, without absolute contraindication of tracheoesophageal puncture. These results may affect salvage surgery concepts.
