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J Korean Soc Laryngol Phoniatr Logop > Volume 19(1); 2008 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2008;19(1): 21-27.
후두 전 절제 환자에서 음성재활을 위한 기관식도발성
왕수건, 장선미
부산대학교 의학전문대학원 이비인후과학교실
Tracheoesophageal Shunt Voice in Total Laryngectomee
Soo-Geun Wang, Sun-Mi Jang
Department of Otorhinolaryngology-Head and Neck Surgery, Busan National University School of Medicine
Total laryngectomy is the most useful procedure tor advanced laryngopharyngeal cancer, but it remains the major problem such as loss of voice. Voice restoration is essential for every patients who undergo a total laryngectomy. Ideal voice rehabilitation methods can resolve three factors. First, every laryngectomee can produce voice sufficient for communication, second every patient should be allowed to use both hands freely during phonation, and last, the voice restoration methods should be easy and safe without complication during and after treatment. Among various voice rehabilitation procedures during or after total laryngectomy, it can be divided electronic and pneumatic methods. In pneumatic methods, there are also divided both pulmonary air and non-pulmonary air methods. The non-pulmonary air methods include esophageal speech, buccal speech, and pharyngeal speech. Pulmonary air methods are divided into surgical and non-surgical such as pneumatic speech aid. In the surgical methods, there are neoglottic operation, tracheopharyngeal shunt, and tracheopharyngeal shunt operations. Recently, tracheoesophageal shunt with or without prosthesis are being recognized the most effective method. Blom-Singer low pressure prosthesis, Panje button, and Provox are well known types of prosthesis in the tracheoesophageal shunt operation. Amatsu method is a kind of famous tracheoesophageal shunt method without using prosthesis. Authors tried to review the published articles for evaluation of effectiveness and problems of tracheoesophageal shunt operation with or without prosthesis. In conclusion, indwelling type of prosthesis and pharyngeal myotomy and plexus neurectomy are recommended for higher success rate during tracheoesophageal puncture procedure. More over, Amatsu method is also one of the recommended voice rehabilitation procedure during total laryngectomy. In this situation, pharyngeal myotomy and plexus neurectomy may be helpful for better fluent communication.
KEY WORDS: Tracheoesophageal;Voice;Laryngectomy;
중심 단어: 후두 전 절제술;음성;기관식도 발성;
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