SURGICAL RESTORATION OF VOICE FOLLOWING TOTAL LARYNGECTOMY USING A MODIFICATION OF ASAIS LARYNGOPLASTY

A new technique of primary neoglottic reconstruction for surgical restoration of voice following total laryngectomy is described in detail. The procedure is based on the principle of Asai's technique, but can be performed as a one-step procedure. Within the last 2 years, the technique has been used in 20 patients with T2-T4 tumors without subglottic extensions and without extensive infiltration of the hypopharyngeal mucosa. The mean period of observation was 14.2 +/- 5.5 months. In two patients the speech fistula had to be removed because of aspiration problems, while six patients required dilatations of the fistula because of stenosis. As a long-term result a satisfactory voice was achieved without aspiration problems in 17 of 20 patients.