Overview of 100 patients with voice prosthesis after total laryngectomy--experience of single institution [Pregled 100 bolesnika sa govornom protezom nakon totalne laringektomije]

Lukinović, Juraj and Bilić, Mario and Raguž, Ivan and Živković, Tamara and Kovač-Bilić, Lana and Prgomet, Drago (2012) Overview of 100 patients with voice prosthesis after total laryngectomy--experience of single institution [Pregled 100 bolesnika sa govornom protezom nakon totalne laringektomije]. Collegium Antropologicum, 36 (S. 2). pp. 99-102. ISSN 0350-6134

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Abstract

Surgical procedures, especially total laryngectomy, used for treatment of advanced laryngeal carcinoma, have a profound adverse effect on the patient's physical, functional, and emotional health, and almost always decrease quality of life. There are three main types of voice rehabilitation after surgery. They are: esophageal speech techniques, the use of artificial larynx devices and tracheoesophageal puncture with the insertion of various types of voice prostheses. Voice prosthesis was inserted in 100 patients in the ENT Department, University Hospital Center Zagreb, from January 2004 until February 2011, and 91 of these patients were included in our study. The prosthesis was inserted secondary at 71 patients, while in other 20 it was inserted primary, i.e. immediately after laryngectomy as a part of the same procedure. Voice rehabilitation was initiated 10th day after primary insertion and 1st-3rd day after secondary insertion. The postoperative voice quality was compared with a five degree scale, which was taken from Hilger's retrospective study (2000). The rehabilitation was successful in 75.8% of our patients. Early complication rate was 4.4%, and 10.9% of patients had late complications. Statistical analysis didn't show significant differences regarding the complications rate and success rate of rehabilitation between groups of patients, formed according to age, irradiation status and timing of prosthesis insertion.

Abstract in Croatian

Kirurški zahvati koji se koriste u liječenju karcinoma grkljana, a posebno totalna laringektomija, imaju izražen negativni učinak na fizičko, funkcionalno i emocionalno zdravlje bolesnika i gotovo uvijek snižavaju životnu kvalitetu bolesnika. Postoje tri glavne skupine glasovne rehabilitacije nakon zahvata. To su: ezofagealni govor, govor upotrebom elektrolarinksa i traheoezofagealna fistulizacija sa ugradnjom govorne proteze. Na Klinici za otorinolaringologiju KBC Zagreb je ugrađeno 100 govornih proteza od siječnja 2004. do veljače 2011. U studiju je uvršten 91 bolesnik. Kod 71 bolesnika su one ugrađene sekundarno, a kod 20 primarno, dakle istodobno kada i laringektomija. Rehabilitacija je započimana 10. dana nakon primarne ugradnje, te već 1.–3. nakon sekundarne ugradnje. Postoperativna kvaliteta glasa je uspoređivana sa 5 stupanjskom ljestvicom, uzetom iz Hilgerove retrospektivne studije (2000.). 75,8% bolesnika je uspješno rehabilitirano, uz stopu ranih komplikacija 4,4%. Stopa kasnih komplikacija je bila 10,9%. Statistička analiza nije pokazala značajne razlike između uspješnosti rehabilitacije kod skupina bolesnika, formiranih na osnovu dobi, prethodnog zračenja i vremena ugradnje.

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