Long-Term Assessment of Speech and Swallowing Function in Laryngopharyngeal Cancer Patients After J-Flap Reconstruction

Objectives. A novel J-shaped anterolateral thigh (ALT) flap reconstruction technique was developed to simultaneously restore swallowing and speech functions in patients following total laryngopharyngectomy. This study aimed to assess the outcomes and surgical complications in patients who underwent...

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Main Authors: Yi-An Lu, Chung-Kan Tsao, Li-Jen Hsin, Hsiu-Feng Chuang, Tuan-Jen Fang
Format: Article
Language:English
Published: Korean Society of Otorhinolaryngology-Head and Neck Surgery 2024-11-01
Series:Clinical and Experimental Otorhinolaryngology
Subjects:
Online Access:http://e-ceo.org/upload/pdf/ceo-2024-00109.pdf
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author Yi-An Lu
Chung-Kan Tsao
Li-Jen Hsin
Hsiu-Feng Chuang
Tuan-Jen Fang
author_facet Yi-An Lu
Chung-Kan Tsao
Li-Jen Hsin
Hsiu-Feng Chuang
Tuan-Jen Fang
author_sort Yi-An Lu
collection DOAJ
description Objectives. A novel J-shaped anterolateral thigh (ALT) flap reconstruction technique was developed to simultaneously restore swallowing and speech functions in patients following total laryngopharyngectomy. This study aimed to assess the outcomes and surgical complications in patients who underwent J-flap reconstruction over time. Methods. Patients who underwent J-shaped ALT flap phonatory tube reconstruction were enrolled. Surgical morbidities and outcomes were evaluated every 3 months post-surgery for a period of 12 months or until death. Results. Of the 36 patients, 13 underwent circumferential pharyngeal wall resection (circumferential defect [CD] group), and 23 underwent partial resection (partial defect [PD] group). After 12 months, 97% of the patients were able to resume oral intake without the need for a nasogastric tube, and 50% achieved fluent speech using the reconstructed phonatory tube. The CD group experienced a higher rate of delayed healing than the PD group (30.8% vs. 0%, p=0.012). Additionally, the PD group showed significantly higher percentages of individuals consuming solid food at both the 3- and 12-month intervals than the CD group (81.0% vs. 23.1% and 78.9% vs. 40%, respectively). Conclusions. This study investigated the progression of speech and swallowing functions over time after reconstruction of the voice tube with a J-flap. Using a J-shaped ALT flap phonatory tube effectively restored both speech and swallowing functions, providing long-term benefits, regardless of whether the defect was circumferential or partial.
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institution Kabale University
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2005-0720
language English
publishDate 2024-11-01
publisher Korean Society of Otorhinolaryngology-Head and Neck Surgery
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series Clinical and Experimental Otorhinolaryngology
spelling doaj-art-5c3367f2c2b84757a7c4b5711a01dcfb2024-12-06T07:43:26ZengKorean Society of Otorhinolaryngology-Head and Neck SurgeryClinical and Experimental Otorhinolaryngology1976-87102005-07202024-11-0117434635410.21053/ceo.2024.00109918Long-Term Assessment of Speech and Swallowing Function in Laryngopharyngeal Cancer Patients After J-Flap ReconstructionYi-An Lu0Chung-Kan Tsao1Li-Jen Hsin2Hsiu-Feng Chuang3Tuan-Jen Fang4 Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan School of Medicine, Chang Gung University, Taoyuan, Taiwan Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, TaiwanObjectives. A novel J-shaped anterolateral thigh (ALT) flap reconstruction technique was developed to simultaneously restore swallowing and speech functions in patients following total laryngopharyngectomy. This study aimed to assess the outcomes and surgical complications in patients who underwent J-flap reconstruction over time. Methods. Patients who underwent J-shaped ALT flap phonatory tube reconstruction were enrolled. Surgical morbidities and outcomes were evaluated every 3 months post-surgery for a period of 12 months or until death. Results. Of the 36 patients, 13 underwent circumferential pharyngeal wall resection (circumferential defect [CD] group), and 23 underwent partial resection (partial defect [PD] group). After 12 months, 97% of the patients were able to resume oral intake without the need for a nasogastric tube, and 50% achieved fluent speech using the reconstructed phonatory tube. The CD group experienced a higher rate of delayed healing than the PD group (30.8% vs. 0%, p=0.012). Additionally, the PD group showed significantly higher percentages of individuals consuming solid food at both the 3- and 12-month intervals than the CD group (81.0% vs. 23.1% and 78.9% vs. 40%, respectively). Conclusions. This study investigated the progression of speech and swallowing functions over time after reconstruction of the voice tube with a J-flap. Using a J-shaped ALT flap phonatory tube effectively restored both speech and swallowing functions, providing long-term benefits, regardless of whether the defect was circumferential or partial.http://e-ceo.org/upload/pdf/ceo-2024-00109.pdflaryngopharyngeal neoplasmssurgical flapsspeech disordersswallowing disordersquality of lifelaryngectomyreconstructive surgical procedures
spellingShingle Yi-An Lu
Chung-Kan Tsao
Li-Jen Hsin
Hsiu-Feng Chuang
Tuan-Jen Fang
Long-Term Assessment of Speech and Swallowing Function in Laryngopharyngeal Cancer Patients After J-Flap Reconstruction
Clinical and Experimental Otorhinolaryngology
laryngopharyngeal neoplasms
surgical flaps
speech disorders
swallowing disorders
quality of life
laryngectomy
reconstructive surgical procedures
title Long-Term Assessment of Speech and Swallowing Function in Laryngopharyngeal Cancer Patients After J-Flap Reconstruction
title_full Long-Term Assessment of Speech and Swallowing Function in Laryngopharyngeal Cancer Patients After J-Flap Reconstruction
title_fullStr Long-Term Assessment of Speech and Swallowing Function in Laryngopharyngeal Cancer Patients After J-Flap Reconstruction
title_full_unstemmed Long-Term Assessment of Speech and Swallowing Function in Laryngopharyngeal Cancer Patients After J-Flap Reconstruction
title_short Long-Term Assessment of Speech and Swallowing Function in Laryngopharyngeal Cancer Patients After J-Flap Reconstruction
title_sort long term assessment of speech and swallowing function in laryngopharyngeal cancer patients after j flap reconstruction
topic laryngopharyngeal neoplasms
surgical flaps
speech disorders
swallowing disorders
quality of life
laryngectomy
reconstructive surgical procedures
url http://e-ceo.org/upload/pdf/ceo-2024-00109.pdf
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