Article

The case of a 68-year-old woman with postoperative speech and swallowing problems
following a circumferential pharyngolaryngectomy and neopharyngeal reconstruction
with a jejunal free flap is presented. The primary tumor was an extended
papillary thyroid carcinoma (pT4N0M0). For vocal restoration, an indwelling
Provox((R)) 1 voice prosthesis was inserted secondarily. The patient received
speech and swallowing therapy, including digital maneuvers at the level of the
proximal (cervical) part of the jejunal graft to improve speech and swallowing
function. Pre- and/ or post-treatment data on speech and swallowing function were
gathered using the following assessment methods: esophageal insufflation test,
Voice Handicap Index (VHI), videofluoroscopy of phonation (VFSph), digital
high-speed endoscopy of jejunal vibration during voice production, fiber-optic
endoscopic evaluation of swallowing (FEES), and videofluoroscopy of swallowing
(VFSs). This case clearly demonstrates that even after extensive
laryngopharyngectomy with jejunal free flap reconstruction, a tailored
rehabilitation program can improve both voice and swallowing function, and that
these results clearly can be objectified/visualized, underlining the validity of
this approach.

Langue : ANGLAIS