[A long-term observation of 48 cases of tracheoesophageal shunt phonation by the anastomosis of the membranous portion of the tracheal section with the anterior wall of esophagus after total laryngectomy].

OBJECTIVE: To study the long-term efficacy of tracheoesophageal (TE) shunt phonation by the anastomosis of the membranous portion of the tracheal section with the anterior wall of esophagus after total laryngectomy. METHODS: A questionnaire was designed to follow 48 patients with rehabilitated speech and swallow functions by the above approach. The qualities of phonation and speech, and the degree of aspiration evaluated, together with the survival rate and complications statistically analyzed. RESULTS: The speech level of 35 laryngectomees was similar to the normal laryngeal speech level. Thirty-five cases had longer maximal phonation time and hearing distance and higher speech intelligibility. Other 5 laryngectomees had less effective phonation, but higher speech intelligibility. The total effective rate was 83.3% (40/48). The speech fluency in 40 laryngectomees was not as good as that in the normal people. Forty percent laryngectomees(16/40) had slight liquid food aspiration which did not influence normal eating. Eight patients(8/48) failed to speak and no liquid aspiration occurred after the operation. The effective rate was affected obviously by neck infection and pharyngeal fistula formation. The survival rate was similar to those with single total laryngectomy. CONCLUSIONS: The TE shunt phonation had the advantages of simple, one-stage operation and high success rate. Some laryngectomees had slight liquid food aspiration, but would not influence normal eating. So this TE shunt phonation operation may be useful during laryngeal surgery.