Larynx Transplantation : Laryngectomees' Opinion Poll. Commentary

Background. In 1998, Strome et al. performed the first human larynx transplantation in a patient with larynx trauma-tism. L'Association Nationale des Mutiles de la Voix, a French association of laryngectomees, estimates that the number of laryngectomees in France has reached 20,000. The main goal of the study was to determine the potential number of patients ready to benefit from larynx transplantation in France. Methods. We carried out a public opinion poll among 420 total laryngectomees in Rhone-Alpes, in the southeast of France. The questionnaire could be divided into three parts: demographic data; incapacities and deficiencies of the patients; and acceptability of larynx transplantation according to short-, medium-, and long-term implications. Results. We received 205 answers from 420 questionnaires (48.8%). Sixty-three patients (i.e., 30.7%) would accept larynx transplantation, especially the younger patients. The patients more willingly accepted the medical constraints (e.g., medical follow-up, rehabilitation) than they did vital (after the operation or because of the treatments) or functional (risk of permanent canula, no guarantee of laryngeal voice, no guarantee of swallowing) risks. Conclusions. Even though this opinion poll has intrinsic bias and acceptance rate is low, by interpolation, larynx transplantation would interest many patients in France. Larynx transplantation is an intervention that should be proposed to a certain number of patients in the future with the help of new immunosuppressor treatments.