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Surgical voice restoration following laryngectomy: the tracheo‐oesophageal fistula technique (Singer‐Blom)
Author(s) -
Perry Alison
Publication year - 1988
Publication title -
international journal of language and communication disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.101
H-Index - 67
eISSN - 1460-6984
pISSN - 1368-2822
DOI - 10.3109/13682828809019873
Subject(s) - laryngectomy , medicine , surgery , voice prosthesis , fistula , larynx
Surgical voice restoration, as described by Singer and Blom, provides a valid means of restoring speech after laryngectomy. It is an endoscopic technique to surgically create a tracheo‐oesophageal fistula or ‘puncture’ into which is later fitted a voice prosthesis. A controlled midline puncture is created endoscopically under general anaesthetic and stented with a 14 French gauge catheter that extends from the trachea into the oesophagus and stomach for at least 48 hours. Results in the primary series, i.e. those given voice restoration at the time of initial laryngectomy, have been exceptionally good (94 per cent successful at 3 months postsurgery). The success rates in the secondary series, i.e. those receiving a tracheo‐oesophageal ‘puncture’ months, or years, postlaryngectomy, have been less good (79 per cent at 3 months). This paper examines the reasons for those failures and indicates ways of improving the selection of patients for this procedure.