喉全切除发音重建术远期疗效分析

Long-term effect of voice rehabilitation in 125 patients following total laryngectomy]

One hundred and twenty-five patients received voice rehabilitation operations following total laryngectomy over the period from August 1977 to December 1994. Among them, 119 were male and 6 were female, the eldest was 70 years old and the youngest 30 years old, and the average age was 55.3 years. Clinical staging was as follows: stage II, 2 cases; stage III, 45 cases; stage IV, 66 cases; and recurrence, 12 cases. The voice rehabilitation operations included pharynx-trachea anastomosis 18 cases and trachea-esophagus fistulization 107 cases. One hundred and fourteen patients were followed-up for 13 months to 18 years. The 3, 5, and 10 year survival rates were 78.2%, 61.4%, and 40.5% respectively. The effective rates of voice rehabilitation according to hearing voice distance were 84.6%, 81.1%, and 67.5% 3 weeks, 1 year, and 5 years respectively after operation. The causes of failure were closure of fistula 15 cases; food aspiration 8 cases and unknown 3 cases. The clinical value, advantages and disadvantages of voice rehabilitation, and the time to evaluate the effect of voice rehabilitation were discussed.