[First experiences with voice-rehabilitative laryngectomy, as described by Staffieri and Amatsu (author's transl)]

Abstract

Report on six cases of tracheo-esophageal shunt-operations as described by Staffieri, and four cases operated according to Amatsu. Both methods hold in common the construction of a slit-like anastomosis between trachea and hypopharynx, respectively upper esophagus. According to Staffieri the anastomosis is made towards the hypopharynx, according to Amatsu towards the upper esophagus. Advantages of the Amatsu-method, as compared to the Staffieri-method, are as follows: 1. no additional hypopharynx-mucosa is required to establish the shunt. Therefore, it is also suited for tumors with loss of pharynx-mucosa, 2. when constructing the anastomosis, mucosa of esophagus, and of trachea, is directly and seamlessly connected so that no granulations or polyps can develop, 3. voice and speech is learned earlier, 4. less aspiration. Both methods have the following disadvantages: 1. for voice-production, the tracheostoma has to be occluded with a finger, 2. a certain amount of aspiration must always be reckoned with, though, up to now, no patient asked for an occlusion of the fistula. At the time being, we are recommending the shunt-method to those patients only who expressly ask for it because of the possibility of early voice-production, and a better quality of speech. Or we recommend it to such patients as would otherwise not consent to laryngectomy.