Functional laryngeal surgery - critical determinants of successful rehabilitation

功能性喉部手术——成功康复的关键决定因素

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Abstract

This study addresses the functional outcome and rehabilitative process in 30 partial laryngectomies carried out for laryngeal (22) und hypoorpharyngeal (8) cancers at the department of H/N Surgery, The kidwai Memorial Institute of Oncology. Bangalore, India from 1985-1995, Special emphasis is directed towards post-surgical convalescence after various partial laryngeetomy techniques which include 6 vertical laryngectomies (V L / VPL). 17 supraglottic laryngectomies (SG L), and 7 supracricoid laryngectomies with Cricohyoidepexy (CHP). Rehabilitative success was measured with respect to the ease of dccannulation, resumption of normal deglutition and speech analysis - both objectively using standard speech analytical equipment in a speech laboratory and subjectively using the services of blinded judges to score recorded speech of patients. The speech analysis indicate that past SGL speech was the superior most followed by V L and C H P in that order. Aspiration was deemed as minimal and inconsequential after V L/VPL followed by CHP;and SGL, in the order of severity;the extended modifications to resect the arytenoid and / or basE of tongue and / or piriform fossa faring worse than classic standard technique.

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