Our Summary

This research study is about a surgical procedure used to help patients recover their ability to speak after having their larynx (voice box) completely removed, a procedure known as a total laryngectomy. This is particularly important for patients in developing countries. The technique involves using a flap of muscle and skin from the neck (known as an infrahyoid musculocutaneous flap) to create a new tube for sound production.

The study involved 18 male patients who had undergone total laryngectomies. The infrahyoid musculocutaneous flap was sewn to the opening of the windpipe, and then connected to the throat to create a way for air to travel and produce sound.

The procedure was successful in most cases, with 17 out of 18 flaps surviving and only one failing. There were no serious complications, although some patients experienced a mild cough when drinking water, which could be relieved by blocking the opening of the windpipe. A year after the operation, all patients were able to speak more clearly and consistently.

The study concluded that this method of using an infrahyoid musculocutaneous flap is a feasible way to restore voice in patients who have undergone a total laryngectomy.

FAQs

  1. What is the purpose of the surgical procedure discussed in the research study?
  2. How successful was the procedure in the study involving 18 male patients who had undergone total laryngectomies?
  3. What complications, if any, did the patients experience after the surgical procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laryngectomy is to practice good communication techniques such as using hand gestures, writing, or electronic devices to help communicate effectively while recovering from the procedure. It is also important to attend speech therapy sessions to learn how to use the new voice production method and improve speech clarity. Additionally, staying hydrated and avoiding irritants such as smoke and pollution can help maintain the health of the new voice production system.

Suitable For

Patients who have undergone a total laryngectomy, usually due to laryngeal cancer or other diseases affecting the larynx, are typically recommended for this procedure. These patients may have difficulty speaking or producing sound after the removal of their voice box, and may benefit from a surgical intervention to help restore their ability to communicate verbally. This procedure may be particularly important for patients in developing countries where access to advanced medical technologies and rehabilitation services may be limited.

Timeline

Timeline before and after laryngectomy:

Before laryngectomy:

  • Patient is diagnosed with a condition that requires the removal of their larynx (voice box).
  • Patient undergoes pre-operative evaluations and tests to determine the best course of treatment.
  • Patient undergoes counseling and education about the procedure and potential outcomes.
  • Patient may undergo radiation or chemotherapy as part of their treatment plan.

After laryngectomy:

  • Patient undergoes total laryngectomy surgery to remove the larynx.
  • Patient may temporarily have a tracheostomy tube to help with breathing.
  • Patient goes through a recovery period in the hospital, receiving care and support from medical staff.
  • Patient begins speech therapy to learn new methods of communication, such as esophageal speech or the use of a voice prosthesis.
  • Patient may experience changes in their ability to swallow and may need to adjust their diet and eating habits.
  • Patient may experience emotional and psychological challenges related to the loss of their voice and changes in their appearance.
  • Patient gradually adjusts to life without a larynx, learning to communicate effectively and adapt to their new way of speaking.

Overall, the timeline of a patient before and after laryngectomy involves a series of medical procedures, emotional adjustments, and lifestyle changes as they adapt to life without their voice box. With proper care and support, patients can learn to communicate effectively and lead fulfilling lives after undergoing a laryngectomy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laryngectomy include:

  1. What are the potential risks and complications associated with a total laryngectomy surgery?
  2. How long is the recovery process after a total laryngectomy, and what can I expect during this time?
  3. Will I still be able to speak after a total laryngectomy, and if so, what methods will be used to help me communicate?
  4. What are the long-term effects of a total laryngectomy on my ability to swallow, breathe, and communicate?
  5. Will I need any additional therapy or support services after the surgery to help me adjust to the changes in my voice and communication abilities?
  6. Are there any alternative treatments or procedures available for restoring voice after a total laryngectomy that I should consider?
  7. How often will I need to follow up with my doctor after the surgery, and what signs or symptoms should I watch for that may indicate a complication?
  8. Will I need to make any lifestyle or dietary changes after a total laryngectomy to support my recovery and overall health?
  9. Can you provide me with information or resources about support groups or organizations for individuals who have undergone a total laryngectomy?
  10. What is the success rate of using an infrahyoid musculocutaneous flap to restore voice in patients who have had a total laryngectomy, and do you have experience performing this procedure?

Reference

Authors: Li C, Fang Y, Wu H, Shu M, Cheng L, He P. Journal: Acta Otolaryngol. 2021 Apr;141(4):408-413. doi: 10.1080/00016489.2021.1877347. Epub 2021 Feb 13. PMID: 33586573