Caner KILIÇ, Ümit TUNÇEL, Ela CÖMERT

10420

Total larenjektomi sonrası ses restorasyonu için provox 2 kullanımı

Amaç: Bu çalışmada konuşma rehabilitasyonu için provox 2 ses protezi kullandığımız hastaların protezleri ile ilgili karşılaştığı sorunlar ve bu hastaların yaşam kalitesini artırmak için uyguladığımız tedavi yöntemleri belirlendi.Hastalar ve Yöntemler: Total larenjektomi yapılan, ses restorasyonu için provox 2 ses protezi takılıp, değişimi yapılan toplam 210 hasta 180 erkek, 30 kadın; ort. yaş 58±11.9 yıl; dağılım 37-83 yıl çalışmaya alındı. Hastaların ses restorasyonu için, primer ameliyat sırası ve sekonder ameliyat sonrası trakeözofageal fistül açıldı. Ameliyat sonrası 15. günde provox 2 ses protezleri, trakeostomanın yaklaşık 0.5 cm inferior ve orta hattaki fistül hattına yerleştirildi. Hastalarla konuşma egzersizleri yapıldı.Bulgular: Protez değişim süresi ortalama 7.5 ay dağılım 1- 48 ay idi. Ses protezi takılan hastaların 141’inde %66 mantar kolonizasyonu saptandı. Otuzunda %14 ses protezi etrafında granülasyon dokusu gelişti, üçü %1 ses protezini yuttu, ikisinin %1 trakeoözofageal fistül genişliği kalıcı oldu ve bu hastalar için ses protezi kullanımından vazgeçildi. Bir hastada da %1 mediastinit gelişti.Sonuç: Komplikasyonlara rağmen yüksek konuşma başarısı ve bu komplikasyonlarla mücadelenin kolay olması gibi nedenlerden dolayı ses restorasyonu için provox ses protezi kullanmak etkili bir yöntemdir
Anahtar Kelimeler:

Komplikasyon, larenjektomi, ses restorasyonu

Provox 2 use for voice restoration after total laryngectomy

Objectives: This study aims to determine the problems of patients applied provox 2 voice prosthesis for speech rehabilitation with their prosthesis and our treatment modalities to increase the quality of life of these patients. Patients and Methods: A total of 210 patients 180 males, 30 females; mean age 58±11.9 years; range 37 to 83 years who underwent total laryngectomy, applied and changed provox 2 voice prosthesis for voice restoration were included in the study. For speech restoration of the patients with a primary intraoperative and secondary postoperative tracheoesophageal fistula was opened. In the 15th postoperative day, provox 2 voice prosthesis was placed to approximately 0.5 cm inferior and midline fistula line of the tracheostoma. The patients underwent speech exercises. Results: The mean change time of prosthesis was 7.5 months range 1 to 48 months . Fungal colonization was detected in 141 patients 66% who had voice prostheses. Granulation tissue developed around the voice prosthesis in 30 patients 14% , three patients 1% swallowed their voice prosthesis, tracheoesophageal fistula width remained permanently in two patients 1% , and these patients were abandoned to use their voice prosthesis. Mediastinitis occurred in one patient 1% . Conclusion: Due to several reasons such as success of high speech despite of complications and being easy to fight with these complications, provox voice prosthesis is an effective method to use for voice restoration.
Keywords:

Complication, laryngectomy, voice restoration,

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The Turkish Journal of Ear Nose and Throat-Cover
  • ISSN: 2602-4837
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1991
  • Yayıncı: İstanbul Üniversitesi
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Total larenjektomi sonrası ses restorasyonu için provox 2 kullanımı

Caner KILIÇ, Ümit TUNÇEL, Ela CÖMERT