Subject(s)
Laryngectomy/rehabilitation , Larynx, Artificial , Patient Satisfaction , Quality of Life , Aged , Aged, 80 and over , Female , Humans , Laryngeal Neoplasms/surgery , Male , Middle Aged , Postoperative Complications/surgery , Speech Intelligibility , Speech, Esophageal/methods , Surveys and Questionnaires , Trachea/surgery , Voice Quality , Voice TrainingABSTRACT
Head and neck surgery has witnessed an increase in microvascular reconstructive procedures with free flaps over the last 20 years as they offer efficient functional recovery. Nevertheless, under certain circumstances they may be contraindicated or cannot be used. We present the use of supraclavicular pedicled flap in three patients with different recipient sites. All patients had acceptable functional and aesthetic outcomes. Donor-site morbidity was satisfactory. Supraclavicular pedicled flap is not only an alternative to free flap reconstruction, but also a first-choice option in head and neck reconstructive surgery.
Subject(s)
Carcinoma, Squamous Cell/surgery , Head and Neck Neoplasms/surgery , Plastic Surgery Procedures/methods , Surgical Flaps , Aged , Aged, 80 and over , Female , Humans , Middle AgedABSTRACT
Previous reports focusing on the high prevalence of voice disorders in teachers have suggested that vocal loading might be the main causal factor. The aim of our study was to assess the prevalence of voice disorders in a sample of primary school teachers and evaluate possible cofactors. Our sample was composed of 157 teachers (155 females, mean age 46 years). Participants were asked to complete two selfadministrated questionnaires: one with clinical data, and the second an Italian validated translation of VHI (voice handicap index). On the same day they also underwent a laryngostroboscopic exam and logopedic evaluation. The results were compared with those of a control group composed of accompanying individuals. Teachers presented a higher rate of abnormalities at laryngostroboscopic examination than the control group (51.6% vs. 16%, respectively). Among these, 7.1% presented nodules. In our sample, vocal fold disorders were not correlated with years of teaching, smoking, coffee consumption, or levels of anxiety. Our findings are in agreement with previous reports on the prevalence of pathologic disorders among teachers; nonetheless, the prevalence of nodules was lower than in previous investigations, and voice loading was not correlated with laryngostroboscopic findings. Current Italian law does not include any guidance regarding voice education and screening in subjects with high vocal loading. Our work stresses the need for such legislation.
