IS THE LARYNGOPLASTY A SUCCESSFUL METHOD AFTER TOTAL LARYNGECTOMY

Laryngoplasty as outlined by STAFFIERI (1973) is a new surgical tech­ nique for vocal rehabilitation after total laryngectomy. After the crea­ tion of the neoglottis however many complications such as aspiration and narrowing occur. Out of 36 patients who underwent total laryn­ gectomy and vocal rehabilitation with the technique of Staffieri 13 achieved a good result. Twenty-three patients failed to develop voice production as a result of altered swallowing function. The treatment of laryngeal cancer today definitely tends to favor conserva­ tive, i.e. functional surgery. Laryngoplasty is a new surgical technique for vocal rehabilitation after total laryngectomy. However, total laryngectomy stilI remains the only available technique in a large percentage of cases. Laryngo­ plastic techniques have been developed with the aim of obviating the sequelae of this mutilating surgery (AMATSU, 1978). This technique undertakes the ambitious task of restoring phonation without eliminating the permanent tracheostoma. This is achieved by means of a small tracheo-pharyngostoma, through which the flow of the air from the lungs is di­ rected toward the upper resonators (oral cavity) whenever the tracheostoma is closed with a finger on exhalation. This produces a voice of good quality with a natural sounding timbre, while aspiration of foods and saliva into the bronchial tree is expected to be prevented by the small size of the fistula. After initial enthusiastic reports about the functional results of this technique critical comments have been published recently (MANN, LANIADO, and SCHUMANN, 1980). This report deals with our experience with the functional results in 36 cases of total laryngectomy and the creation of the phonatory neoglottis as ad­ vocated by Staffieri 3 years after operation.