gms | German Medical Science

79. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

30.04. - 04.05.2008, Bonn

Laryngoplasty after total laryngectomy – experiences with voice rehabilitation with the microvascular radial forearm flap according to Hagen

Meeting Abstract

Suche in Medline nach

  • corresponding author Thoralf Stange - Lukaskrankenhaus Neuss, ENT-Department, Neuss, Germany
  • Hans-Jürgen Schultz-Coulon - Lukaskrankenhaus Neuss, ENT-Department, Neuss, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Bonn, 30.04.-04.05.2008. Düsseldorf, Köln: German Medical Science; 2008. Doc08hno42

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2008/08hno42.shtml

Veröffentlicht: 8. Juli 2008

© 2008 Stange et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

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.


References

1.
Hagen R. Voice rehabilitation after total laryngectomy: a microvascular substitute larynx tube (laryngoplasty) instead of a voice prosthesis. Laryngorhinootologie. 1990;69:213-6.