Abstract
Tracheoesophageal (TE) fistulization following pharyngolaryngectomy and tracheojejunal (TJ) fistulization following pharyngolaryngo-esophagectomy with free jejunum reconstruction for advanced hypopharyngeal and cervical esophageal cancer have been performed over the past 20 years at Kobe University Hospital.Out of 42 patients who underwent TE fistulization and 19 patients who received TJ fistulization, 32 patients (76%) and 16 patients (84%) regained voice capability with TE and TJ speech, respectively. The main causes of restoration failure were stenosis, the destruction of the TE or TJ fistula and a lack of motivation on the part of the patients. Most patients who underwent the TE or TJ procedure started speaking at 1 month postoperatively. The average values of the sustained vowel duration in the group of TE speakers and TJ speakers were 18 seconds and 11 seconds, respectively, at month. As far as the swallowing function is concerned, no regurgitation or aspiration was seen in 24 of the TE speakers (75%), with the use of bilateral esophageal muscle flaps, and in 15 of the TJ speakers (94%).
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