Voice rehabilitation after total laryngectomy with the infrahyoid musculocutaneous flap

Abstract

Background

It is important for the patients to reconstruct the voice phonic function by surgery after total laryngectomy in the developing countries.

Aims/Objectives

To investigate the clinical outcomes of voice reconstruction using an infrahyoid musculocutaneous flap for patients after total laryngectomies.

Materials and methods

Eighteen male patients recruited were laryngectomized. The infrahyoid musculocutaneous flap was designed. After total laryngectomy, the lower edge of the flap was sewed with the upper edge of the tracheostomy opening. Next, the lateral and medial edges of the flap were anastomosed to create a pronunciation tube. Finally, the remaining opening of the tube was sutured with the anterolateral wall of the hypopharynx to establish a communication with the pharyngeal cavity.

Results

A total of 17 cases of flaps were survived and only 1 necrosed. There were 17 patients without serious complications, except that 6 cases had mild irritable cough when gulping water. However, it could be relieved through blocking tracheostoma. One year after operation, all patients could more remarkably articulate clear, powerful, and consistent words. The articulatory configuration was existed under rigid laryngoscope and CT.

Conclusions and significance

The use of an infrahyoid myocutaneous flap is feasible for the voice restoration in the patients undergoing total laryngectomy.

Chinese abstract

背景：对于发展中国家的患者来说, 在全喉切除术后通过手术重建其语音功能是很重要的。

目的：探讨使用舌下肌皮瓣对全喉切除术后的患者进行语音重建的临床结果。

材料和方法：招募了18名接受全喉切除术的男性患者。设计了舌下肌皮瓣。全喉切除后, 将皮瓣的下边缘与气管切开术开口的上边缘缝接起来。接下来, 将皮瓣的外侧缘和内侧缘缝合以形成发音管。最后, 将管的其余开口与下咽的前外侧壁缝合, 以建立与咽腔的连通。

结果：共17例皮瓣幸存, 仅1例坏死。 17例无严重并发症, 除6例吞咽水时有轻度易激咳嗽, 但可以通过堵塞气管口来缓解。手术后一年, 所有患者都可以更好地表述清晰、有力且一致的单词。在刚性喉镜和CT下可见发音构型。

结论和意义：使用舌下肌皮瓣对全喉切除患者进行语音重建是可行的。

Keywords:

• Infrahyoid musculocutaneous flap
• laryngeal function reconstruction
• total laryngectomy
• voice rehabilitation

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research is supported by the Science and Technology Commission of Shanghai Municipality of China (Grant No. 17411962000) and also supported by the Health and Family Planning Commission of Shanghai Municipality of China (Grant No. 2019SY059).