The evaluation of TE shunt operation in patients with high-dose irradiation

Vocal rehabilitation of laryngectomized patients by means of TE shunt operation became popular in recent years. Since many of the candidates of this operation are heavily irradiated before the surgery, it appears important to evaluate the risk of the irradiation to such operation properly. In this communication, we report the retrospective evaluation of TE shunt operation performed in 16 patients who received 65 Gy or 40 Gy preoperatively. The surgical procedure used was mostly the modified Amatsu method. By this procedure, the duct as the inlet of the air was made by the tracheal wall containing cartilage rings, instead of the tracheal mucosa only. Minor wound complication occurred in 3 of 10 patients with 65 Gy irradiation but this did not ruin the shunt. Twelve patients (75 %) acquired satisfactory phonation after the surgery but 4 failed because of obstruction of the shunt. The aspiration inherent to this operation was generally acceptable, though 5 out of 16 patients (31 %) complained slight leakage of the fluid. Our results show that TE shunt operation is safe enough in those who received high-dose irradiation preoperatively. (author)