[Observation of aspiration of laryngectomees in TE shunt speech without prosthesis]

To investigate the course of variation and influencing factors on aspiration in laryngectomees who underwent tracheoesophageal (TE) shunt speech without prosthesis.

Sixteen laryngeal cancer patients who were operated on for TE shunt voice rehabilitation without prosthesis after total laryngectomy. These laryngectomees experienced aspiration in different degrees after the operation. We designed a questionnaire to follow up alteration aspiration.

Of sixteen laryngectomees, the longest follow-up time was nine years and six months, the shortest time was one year and three months, no one got lost in the follow-up. In the follow-up period, three laryngectomees died, other thirteen still survived. There were three basic aspiration variational courese: Seven patients changed from no leakage to slight leakage. Four patients remained slight leakage. Five patients changed from obvious leakage to slight leakage. Aspiration affect TE shunt speech in four different ways: No leakage, good voice; slight leakage, still good voice. No leakage,hard voice. If speak, take more time and use great effort. However,in some patients, if the slight leakage gradually appeared, the voice seemed to be better. If the slight leakage remained in the same degree,the patient got good voice all the time. Obvious leakage, hard voice. When leakage gradually became slight, voice grew better. There were no laryngectomees had the following situations: obvious leakage all the time, bad voice all the time. It was considered that radiation therapy induced aspiration in six laryngectomees. Neck infection and pharyngeal leak were believed to cause aspiration in five laryngectomees.

Any surgical procedures with good voice, but no postoperative aspiration is the best choice in voice rehabilitation in laryngectomees. However, if some laryngectomees only have slight liquid food aspiration without interference with their normal diet; at the same time, those laryngectomees have high speech level,we consider the operation is acceptable. Definitely, radiation therapy, neck infection and (or) pharyngeal leak have some influence on aspiration. The variational course of aspiration and phonation change affected by aspiration are complex problems which need further investigation.