Biofeedback in Voice Rehabilitation of Patients After Laringextomy

Аim. To study the possibility of using a radiopharmaceutical based on aluminum oxide labeled with 99mТс ([99mТс]-Al2O3) for the diagnosis of sentinel lymph nodes (SLN) in tumors of the larynx and laryngopharynx in comparison with a phytate colloid ([99mTc]-phytate colloid).Materials and methods. The study included patients with cancer of the larynx and laryngopharynx (T2–4N0M0) (n = 54). In the prospective group (n = 30), [99mТс]-Al2O3 was used as a radiopharmaceutical, in the retrospective group (n = 24), [99mТс]-phytate colloid was used. All radiopharmaceuticals were introduced endoscopically into the submucosal space along the periphery of the tumor. After 18 hours, single-photon emission computed tomography (SPECT) and intraoperative SLN detection were performed.Results. In the retrospective group, SLNs were detected in 20 out of 24 patients. A total of 32 lymph nodes were identified in the retrospective group. The median number of detected lymph nodes in one patient was 1.3 [0–3], the intensity of the radiopharmaceutical uptake on scintigrams was 2.2 [0.7–8.1], intraoperatively – 4 [1.6–9.0]. In the prospective group, [99mTc]-Al2O3 uptake in the lymph nodes of the neck was determined in 27 patients (90%); in3 patients, SLNs were not visualized. A total of 57 lymph nodes were identified (in 27 patients). The median number of visualized SLNs was 1.5 [0–5], the intensity of [99mТс]-Al2O3 uptake according to SPECT and intraoperative detection was 4.8 [0.7–19.4] and 6 [1.1–22.0], respectively.Conclusion. The most significant advantage of using [99mТс]-Al2O3 as a radiopharmaceutical is its high uptake in SLNs, which leads to an increase in the sensitivity of the method as a whole up to 90 versus 83% when using [99mTc]-phytate colloid.

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Diagnosis of sentinel lymph nodes in patients with cancer of the larynx and laryngopharynx using a new radiopharmaceutical based on technetium-99m-labeled gamma aluminum oxide

Medvedeva

Chernov

Bragina

et al. 2023

Bûll. sib. med.

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Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy

Daikhes,

Reshulskiy,

Isaeva

et al. 2024

Sib. onkol. ž.

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The study aimed to identify objective predictors of the successful voice rehabilitation after total laryngectomy to select the optimal method of voice restoration.Material and Methods. The study included 60 laryngectomized male patients who were stratified into 2 equal groups depending on the patient’s choice of voice restoration: tracheoesophageal puncture or esophageal voice. A comprehensive assessment of the qualitative and quantitative parameters of the pharyngoesophageal segment was carried out using the diagnostic procedures, such as: fiberoptic endoscopic evaluation of swallowing, high-speed video endoscopy, and high-resolution pharyngoesophageal manometry. The results of examination of the pharyngoesophageal segment were compared with the results of voice rehabilitation.Results. A significant difference in the resting pressure in the pharyngoesophageal segment between patients with successful and unsuccessful voice rehabilitation was found. The resting pressure in the pharyngoesophageal segment was higher in patients with unsuccessful voice rehabilitation than in patients with successful voice rehabilitation. Among patients with failed voice rehabilitation, 64 % had pseudodiverticula, 25 % had cicatricial strictures and 11 % had pharyngospasm. Pseudodiverticula were found only in patients who underwent vertical or apparatus pharyngeal closure. We described vibrating patterns of substitute phonation in laryngectomized patients and identified 5 different types of pseudoglottis. No significant differences between the methods of substitute phonation were found.Conclusion. The state of pharyngoesophageal segment is an objective predictor of successful substitute phonation and depends on the surgical technique of pharyngeal closure, the volume of cancer treatment and the course of the postoperative period. A comprehensive assessment of the qualitative and quantitative parameters of the pharyngoesophageal segment using fiberendoscopic, fuoroscopic studies and highresolution pharyngoesophageal manometry allows prediction of voice rehabilitation outcomes.

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Biofeedback in Voice Rehabilitation of Patients After Laringextomy

Cited by 2 publications

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Diagnosis of sentinel lymph nodes in patients with cancer of the larynx and laryngopharynx using a new radiopharmaceutical based on technetium-99m-labeled gamma aluminum oxide

Diagnosis of sentinel lymph nodes in patients with cancer of the larynx and laryngopharynx using a new radiopharmaceutical based on technetium-99m-labeled gamma aluminum oxide

Objective evaluation of the pharyngoesophageal segment as a source of substitute phonation in patients after total laryngectomy

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