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9 ) Komorn, R. M. et al.: Vocal rehabilitation with a tracheo-esophageal shunt, Arch. Otolaryngol., 97: 303 `305, ) Arslan, M. &Serafini, I.: Restoration of Laryngeal functions after total laryngectomy. Report on the first 25 cases. Laryngoscope, 82: 1349 `4360, ) Iwai, I., & Koike, Y.: Primary laryngoplasty., Arch. Oto-Rhino-Laryng., 206: 1 `10, ) Staffieri, M. & Serafini, K.: La Rehabilitazione chiurgica della voce e della Respirazione dopo laryngectomia totale. ATTI delxxlx Congresso Nationale, Associazone otologi Ospedalieri Italian, Bologna, 28 Septembre-3 Ottobre ) Gussenbauer, C.: Uber die erste durch Th. Billroth an Menschen ausgefiihrte kehlkopf-exstirpation, and die Anwendung eines kiinstlichen kehlkopfes., Verh. Deutsch. Ges. Chir. p.250, ) Park, R.: A case of total extirpation of the larynx., Ann. Surg., 3: 28 `38, ) Guttman, M. R.: Tracheohypopharngeal Fistulization(a new procedure for speech production in the laryngectomized patient)., Trans Am. Laryngol. Rhinol. and 14) Amatsu, M.: A new one-stage surgical technique for postlaryngectomy speech., Arch. Oto-Rhino-Laryng., 220: 149 `152, Otol. Soc., 41: 219 `226, ) Conley, J. J., et al.: A new surgical technique for vocal rehabilitation on the laryngectomized patient, Ann. Otol., 67: 16) Amatsu, M.: A one stage surgical technique for post-laryngectomy voice reha- 655 `664, bilitation, Laryngoscope, 90: 1378 `1386, ) Kitamura, T., et al.: Supracricoid laryngectomy. A new technique for vocal reh- abilitation, Laryngoscope, 80: ,
10 c c Clinical and Bacteriological Studies of Cefoperazone in Otolaryngology K. KURIYAMA, MD et al. Effects of a Large-Dose Administration of Lysozyme Chloride on Maxillary Sinus Mucosa \A Histopathological Study c c S. SAKAI, MD et al. Effects of Histaglobin on Histaminopexic Power in Patients with Nasal Allergy K. UKAI, MD et al. Clinical Evaluation of a New Nonsteroid Analgesic Antiinflammatory Agent, Y-9213 for Pain and Inflammation after Tonsillectomy c ck. KATSUTA, MD et al. Efficacy of New Antihistaminic, LM-209, in Nasal Allergy c ci FURUUCHI, MD et al. Abstracts of Original Papers Surgical Method for Postlaryngectomy Speech Mutsuo Amatsu, MD. Department of Otolaryngology, Kobe University School of Medicine (Director: Prof. H. Hattori, MD) It has been well known, since the first laryngectomy was performed by Billroth in 1873, that air communication between the trachea and the gullet could produce phonation following total laryngectomy. In this article, following a brief historical review regarding postlaryngectomy voice rehabilitation mainly by surgical methods and its classification, the author's tracheo-esophageal shunt operation for postlaryngectomy speech and its results are described. The essential part of the author's technique consists of the construction of a tracheo-esophageal shunt using the posterior wall of the trachea which is exposed at the time of the laryngectomy. Fifty-four out of ninty laryngectomies were operated by using this technique during the past four years. Forty out of fifty-four patients could use the shunt for daily conversation. Fourteen out of fifty-four patients failed in speaking with the shunt. The most frequent and significant cause of failure was obstruction of the esophageal orifice of the shunt. procedure. Irradiation before and after the operation seemed to be not contraindicated for performing the Slight leakage of fluid from the esophagus into the trachea was recognized in sixteen(40%) of forty patients, which was effectively blocked by slight digital pressure. This technique could not be applied to thirty-six out of ninety laryngectomy cases. Ths causes were analysed and discussed. out
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