دراسة مقارنة بين تركيب زر الكلام في أثناء العمل الجراحي و بعده لدى المرضى المجرى لهم استئصال حنجرة تام في مشفى المواساة

الملخص EN

Background & Objective: One of the most effective techniques for speaking following a laryngectomy is voice button.

It can be placed at the time of the original laryngectomy (primary), or at later time (secondary).

Aim of study: Which is the best and easily method to create the fistula and placement the voice prostheses for good results and less complications.

Design of study: prospective study of patients who admitted in AL MOASSAT HOSPITAL and underwent laryngectomy and placement the voice button prosthesis Methods & Materials: Between 1/7/2010 and 1/7/2011, 19 patients underwent to create the fistula and placement the voice prostheses .11 of the patients underwent a primary prosthesis insertion at the time of laryngectomy and 8 are secondary at later time of laryngectomy.

The differences between two methods were study by measured the time of surgery, complications, and vocalizing, and compared between the irradiated and non- irradiated patients.

The results was get after at least 4 months.

Results: Among all patients ; mean age is 58 years ( range ,43 to 85 years ).

The mean time of surgery in primary methods was 12 minutes and in secondary method was 35 minutes .the incidence of vocalizing with the voice button prostheses was 73.5 % (73% in primary and75% in secondary method).

The study of complications from their valves was as follow , the incidence of leakage around the fistula was 13 % (11 % in the primary, 9% in secondary ), the granulation tissue formation was 25% ( 26 %in primary and 27 % in secondary ), the incidence of obstruction of the speech valve was 26% ( 27%in the primary, and 25% in secondary ).

The irradiated patients were associated with a higher rate of complications than non-irradiated patients (leaks of food 10.5 %,0%- the granulation tissue formation15.8%,10.5 %) consequently.

Conclusions: According to my study, use of the voice button as a primary method is an easily and effective methods of postlaryngectomy voice rehabilitation, and it continues to be the preferred method of voice restoration in majority of cases.

The Radiotherapy were not statistically significant in predicting complications in this study because the numbers were small