Surgical voice restoration after total laryngectomy: An overview
Surgical voice restoration after total laryngectomy: An overview
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DOI：
10.4103/0019-509x.64707
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发表时间：
2010-07-01
影响因子：
1
通讯作者：
Rhys-Evans, P. H.
中科院分区：
文献类型：
--
作者：
Elmiyeh, B.;Dwivedi, R. C.;Rhys-Evans, P. H.
全喉切除术可能是一种使人衰弱的手术，会损害一些最基本的生活功能，包括言语和吞咽功能。这可能会对患者的身体、功能和情绪健康产生深远的不利影响，并可能导致生活质量 (QOL) 下降。直到 20 世纪 80 年代，全喉切除术还被认为是一种可怕但通常可以挽救生命的手术，几乎没有其他选择，因此被用作最后的手段。当时，在生活质量方面，不惜一切代价生存是最重要的，许多喉切除者被迫过着与世隔绝的生活，过着沉默寡言、语言障碍的隐士生活。大多数声音恢复尝试都产生了不一致的结果，而且技术往往费力、昂贵且无效，特别是在放射治疗失败后作为挽救程序进行时。过去 30 年来，全喉切除术后发声康复方面的进展对喉癌治疗的整个概念产生了巨大的影响。目前针对这些患者有几种选择，即食管言语、人工喉、气管食管言语。言语康复的选择因患者而异，但气管食管发声已成为首选方法。本文简要介绍了全喉切除术后声音恢复的手术。特别强调了手术技术、特殊考虑、并发症以及气管食管发声恢复的预防/治疗。
Total laryngectomy is potentially a debilitative surgery resulting in compromise of some of the most basic functions of life including speech and swallowing. This may have a profound adverse effect on the patients physical, functional, and emotional health, and may result in a decreased quality of life (QOL). Until the 1980s, total laryngectomy was regarded as a dreadful, but often, life-saving procedure for which there was little alternative, and was used as a last resort. At that time survival at any cost in terms of QOL was paramount and many laryngectomies were forced into an isolated life as a mute and dysphasic recluse. Most attempts at voice restoration produced inconsistent results and often techniques were laborious, expensive, and ineffective, particularly when carried out as a salvage procedure after failed radiotherapy. Progress in voice rehabilitation, following total laryngectomy, over the last 30 years, has made an enormous difference in the whole concept of the management of laryngeal cancers. Currently there are several options available for these patients, namely, esophageal speech, artificial larynx, and tracheoesophageal speech. The choice of speech rehabilitation varies from patient to patient, but tracheoesophageal voice has become the preferred method. This article provides a brief account of surgical voice restoration after total laryngectomy. Special emphasis has been given to the surgical technique, special considerations, complications, and the prevention / treatment of tracheoesophageal voice restoration.