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J Reconstr Microsurg
DOI: 10.1055/a-2320-5029
Original Article

Rehabilitation Program for Postlaryngectomy Patients Following Ileocolon Flap Transfer for Voice Reconstruction: An Essential Part of Success

Kai-Yuan Katie Lin 
1   Department of Medicine, China Medical University, Taichung, Taiwan
,
Chi-wen Huang
2   Department of Plastic Surgery, Prospective Wound Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
,
Shih-Heng Chen
3   Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and Medical College Taoyuan, Taoyuan City, Taiwan
,
Jian-Jr Lee
2   Department of Plastic Surgery, Prospective Wound Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
,
Hung-chi Chen
2   Department of Plastic Surgery, Prospective Wound Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
› Institutsangaben Funding None.
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Abstract

Background Speech restoration is important for communication and social activities after pharyngolaryngectomy in head and neck cancer or corrosive injury. Several techniques of voice restoration have been developed to improve life quality. The aim of this paper was to focus on the microsurgical transfer of ileocolon flap and outcome of further voice rehabilitation.

Patients and Methods From 2010 to 2022, 69 patients had ileocolon flap at our hospital with postoperative speech training and regular follow-up for over 1 year. The patients received deglutition training first, followed by voice rehabilitation. Voice outcomes were evaluated at an interval of 3 months and finally at 12 months of voice training rehabilitation. Among other examinations, the speech function was evaluated using a 4-point Likert scale and senior surgeon (H-c.C.) scoring system.

Results The results showed that speech function reached 13.1% of excellent voice, 65.1% of good voice, 13.1% of fair result, and 8.7% of poor result by Likert scales. Meanwhile, the senior surgeon (H-c.C.) score showed 17.4% of excellent, 63.8% of moderate, and 18.8% of poor results. About voice laboratory results, maximal phonation time was 11.0 seconds, and the average number counted in one breath was 15. Loudness and frequency showed 56.0 dB and 105.0 Hz, respectively.

Conclusion The study showed that after voice reconstruction with ileocolon flap followed by the voice rehabilitation program, the patients would have a better understanding of the altered anatomical structures and practice in a more efficient way. Adequate recommendation by the therapists to plastic surgeons for revision surgeries optimized voice function of the patients.

Keywords

ileocolon flap - laryngectomy - rehabilitation - voice reconstruction

Data Availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.


Ethics Approval

The study was approved by the Institutional Review Board (or Ethics Committee) of China Medical University Hospital (Protocol number: DMR 101-IRB1-167).


“All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.”




Publikationsverlauf

Eingereicht: 30. Oktober 2023

Angenommen: 15. April 2024

Accepted Manuscript online:
06. Mai 2024

Artikel online veröffentlicht:
04. Juni 2024

© 2024. Thieme. All rights reserved.

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