Staffieri's procedure revisited

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Speech Pathology

Background:

• Staffieri's procedure is a surgical technique for voice restoration after total laryngectomy.
• Evaluating long-term outcomes is crucial for established and novel surgical interventions.

Purpose of the Study:

• To assess the long-term efficacy and complications of Staffieri's procedure.
• To compare outcomes with conventional total laryngectomy.

Main Methods:

• Retrospective review of 42 patients undergoing Staffieri's procedure.
• Comparison with 43 patients undergoing conventional total laryngectomy.
• Evaluation of voice production, aspiration, and pharyngocutaneous fistula formation.

Main Results:

• 50% of patients achieved successful voice production.
• 25% experienced neoglottis stenosis, hindering speech.
• 25% had significant aspiration issues.
• Pharyngocutaneous fistula rate was >35% for Staffieri's vs. <20% for conventional laryngectomy.
• Longer postoperative hospital stay in the Staffieri group.

Conclusions:

• Staffieri's procedure demonstrates suboptimal long-term voice restoration and a high complication rate.
• The procedure's benefits do not outweigh its risks, particularly in patients with prior radiotherapy.
• Conventional total laryngectomy appears to offer better outcomes regarding fistula formation.