Total pharyngolaryngectomy and voice reconstruction with ileocolon free flap: Functional outcome and quality of life
Journal
Journal of Plastic, Reconstructive and Aesthetic Surgery
Journal Volume
64
Journal Issue
7
Pages
911-920
Date Issued
2011
Author(s)
Abstract
Total pharyngolaryngectomy (PL) reconstruction with an ileocolon free flap not only restores swallowing but also provides potential for speech. We report our surgical technique, functional outcome and quality of life (QoL) of 17 (15 males and two females) patients who underwent total PL/voice reconstruction with an ileocolon free flap between 2004 and 2009. The patients were retrospectively reviewed and swallowing, speech and QoL evaluated. Speech intelligibility was assessed using Hirose and Chen scoring systems, in addition to sound spectrogram analysis. QoL was evaluated using the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30) in conjunction with the disease-specific Head & Neck Cancer Module (QLQ-H&N35). The mean age of patients was 49 (range 35-69) years and the mean follow-up period was 22 (range 6-72) months. There was one partial flap failure and another flap was successfully salvaged. Swallowing function was achieved by 16 (94%) patients at 4 weeks, whilst 12 (71%) demonstrated moderate-to-excellent speech intelligibility. There were no cases of aspiration pneumonia. QLQ-C30 global QoL and functional subscales indicated patients had average-to-good functioning. Comparison of QLQ-H&N35 scores with EORTC reference values indicated our patients had greater difficulty with social contact, mouth opening and weight gain. Total PL/voice reconstruction with the ileocolon free flap is a viable option in selected patients, who desire autologous voice reconstruction. A low complication rate and reasonable QoL support this reconstructive method. ? 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Subjects
Ileocolon; Quality of life; Speech; Swallow; Total pharyngolaryngectomy; Voice reconstruction
Other Subjects
adult; aged; article; clinical article; European Organization for Research and Treatment of Cancer Core Questionnaire; female; follow up; free tissue graft; functional assessment; Head and Neck Cancer Module; human; ileocolon free flap; laryngectomy; male; priority journal; quality of life; quality of life index; questionnaire; retrospective study; scoring system; social behavior; speech intelligibility; surgical technique; swallowing; throat surgery; total pharyngolaryngectomy; voice; weight gain; Adult; Aged; Cohort Studies; Colon; Female; Follow-Up Studies; Humans; Ileum; Laryngeal Neoplasms; Laryngectomy; Male; Middle Aged; Pharyngeal Neoplasms; Pharyngectomy; Quality of Life; Reconstructive Surgical Procedures; Retrospective Studies; Risk Assessment; Speech Intelligibility; Speech Production Measurement; Speech, Alaryngeal; Surgical Flaps; Treatment Outcome
Type
journal article