Tratamiento de la disfagia en paciente laringectomizado: estudio de caso / Treatment of dysphagia in a laryngectomy patient: a case study

Resumen Por medio del presente estudio se pretende mostrar la aplicación de maniobras deglutorias y técnica de inyección utilizada en el aprendizaje de la voz erigmofónica como estrategias para rehabilitar la disfagia después de la laringectomía total. Se realizó un estudio de caso de una paciente con laringectomía total, faringectomía y reconstrucción con colgajo radial quien presentó disfagia. Se realizó tratamiento fonoaudiológico con maniobras deglutorias y técnica de inyección de aire con resultados satisfactorios para deglución de todas las consistencias Se concluye que las maniobras deglutorias en el manejo del paciente laringectomizado mejoraron la coordinación de la apnea deglutoria, la precisión del contacto dorso palatal, el movimiento peristáltico faríngeo y la activación del esfínter esofágico superior; la técnica de inyección en combinación con las maniobras fortalecieron la acción del esfínter.

Abstract The purpose of this study is to describe the application of the swallowing manoeuvres and the air injection technique used in the training of the oesophageal voice in the treatment of the dysphagia after a total laryngectomy. A case study is presented on a patient with total laryngectomy, pharyngectomy and oesophageal reconstruction with radial flap. The patient presented with oropharyngeal dysphagia. Phono-audiological therapy with swallowing manoeuvres and an air injection technique was performed, with satisfactory results for swallowing of all textures. In conclusion, swallowing manoeuvres in dysphagia after total laryngectomy help to improve the coordination in swallowing apnoea, the contraction of the base of tongue, and the peristaltic movement of the pharynx. The air injection technique, in combination with swallowing manoeuvres, improves the function of the upper oesophageal sphincter.

Clinical Use of Tracheo-oesophageal Voice Prostheses After-laryngectomy / 听力学及言语疾病杂志

Objective The purpose of this study was to evaluate the use of tracheo-oesophageal vioce prostheses after total laryngectomy.Methods Between 1995 and 1999,18 male patients ,Aged from 42 to 68,average 54.6,used Blom-singer voice prostheses after total laryngectomy.10 cases were glottic style,8 cases were subglottic style.12 patients received stage I,6 patients received stage Ⅱ voice reconstruction surgery. Results All cases were followed-up from 3 to 5 years. The success rate was 77.8%(14/18). The time with prostheses ranged from 8 to 19 months(average 12months). All failures were stage Ⅱ surgey .Conclusion Stage I voice reconstruction surgery can be performed in all total laryngectomy patients. But the indications of stage Ⅱ voice reconstruction surgery should be controlled strictly. More attention should be paid to the training of voice rehabilitation after total laryngectomy. The tracheo-oesophageal voice prostheses is an effective method to improve the life quality of the patients.