gms | German Medical Science

78. 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.

16.05. - 20.05.2007, München

Influences of pharyngeal constrictor myotomy and application of voice protheses on the outcome of postlaryngectomy esophageal speech rehabilitation

Meeting Abstract

  • corresponding author Jürgen Borghardt - Rehabilitationsklinik Bad Münder, Akad. Lehrkrankenhaus, Bad Münder
  • Britta Kahmann - Rehabilitationsklinik Bad Münder, Akad. Lehrkrankenhaus der MHH, Bad Münder
  • Christoph Gutenbrunner - Medizinische Hochschule Hannover, Klinik für Physikalische Medizin und Rehabilitation, Hannover
  • Hans-Jürgen Welkoborsky - Klinikum Region Hannover, Krankenhaus Nordstadt, HNO-Klinik, Hannover
  • Wolf Schmidt - Rehabilitationsklinik Bad Münder, Bad Münder

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 78. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. München, 16.-20.05.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07hnod473

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hnod2007/07hnod473.shtml

Veröffentlicht: 24. April 2007

© 2007 Borghardt 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: Esophageal speech requires the patient to inject or inhale air into the oesophagus and expel the air through the surgically created pharyngo-esophageal (PE) segment. A good tonicity of the PE segment to allow vibration is an important factor for good voicing and can be achieved after ph. constr. myotomy. We investigated the effects of myotomy on the results of esophageal speech rehabilitation.

Methods: 527 laryngectomized patients were included in the study over a three years period.The 489 evaluable patients were investigated in four groups: laryngectomy with or without myotomy and with or without additional application of voice prothesis (Provox). Logopaedic treatment was carried out daily with an average number of 21 treatments per patient in a median treatment time of 18 days. The assessment of voice quality was performend at the beginning an end of rehabilitation.

Results: A general improvement of voice restoration, regard-ing all three possibilities of speech reha-bilitation, could be achieved in 95% of the patients with myotomy and in 84% of patients without (p=0,001).322 patients presented at the beginning of rehabilitation without any communication possibility.77% of the myotomy-patients learned esophageal speech in contrast to 62% who were laryngectomized without myotomy (p=0,009). Sub-group analysis showed the highest response for myotomy-patients without Provox with 82,4% (Myotomy + Provox 68,8).Patients without myotomy and without Provox 69,7% (No myotomy+Provox 50%).

Conclusions: 1.For a successful esophageal voice rehabilitation laryngectomy should be performed with myotomy. 2.A standardized logopaedic training program with daily lessons is necessary.3.Application of voice prostheses should be elective and performed only together with myotomy.