Avtor/Urednik		Lichtenberger, Gyorgy
Naslov		Recent aspects, methods and devices for surgical voice rehabilitation after laryngectomy
Prevedeni naslov		Sodobni vidiki, metode in pripomočki za kirurško rehabilitacijo glasu po odstranitvi grla
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 39, št. Suppl 3
Leto izdaje		2000
Obseg		str. 63-8
Jezik		eng
Abstrakt		After Blom and Singer reported about the construction of the so-called "duck bill" prosthesis in 1980 there were newer and newer voice prostheses constructed by other authors year after year. Besides these new constructions of prostheses, new methods were worked out to predict the results, such as the insufflation and lidocain test. As implanting the voice prosthesis with the Blom-Singer method meant some problems and complications in some cases too, author worked out a simplified esophagotracheal puncture-technique instead of it. The pharynx is opened with the laryngoscope that is then led up to the entrance of the esophagus. Through the laryngoscope the distal end of the endo-extralaryngeal needle carrier - developed by the author and modified for mass production by the R. WOLF Ltd, Germany - is led into the esophagus. The instrument is pushed forward as long as its distal bent, blunt end is palpable in the upper third of the tracheostoma. The needle with the thread (2/0 prolene) is pushed through from inside out in the upper third of the tracheostoma. A double wire forming a loop is led through the pointed metal cone (in which there is a needle built in) and the catheter, and it is tied behind a conterfixing pierced ball. The 2/0 prolene leading thread is then knotted with the wire. By pulling the thread and the wire, the pointed end of the metal cone with the needle built in, perforates the soft parts and pulls the catheter with itself. After this procedure the voice prosthesis can be placed easily in the fistula on conventional way.
Izvleček		Po tem, ko sta Blom in Singer leta 1980 poročala o t. i. duck bill protezi, so v naslednjih letih drugi avtorji konstruirali nove in nove govorne proteze. Poleg samih novih protez so bile izdelane tudi nove metode napovedi rezultatov, kot sta insuflacijski in lidokainski test. Ker je vsaditev govorne proteze po Blom-Singerjevi metodi predstavljala določene težave in v nekaterih primerih tudi zaplete, je avtor namesto nje izdelal poenostavljeno tehniko ezofagotrahealne punkcije. Žrelo se pri njej odpre z laringoskopom, ki se ga nato vodi do vhoda v požiralnik. Skozi laringoskop se v požiralnik vodi distalni konec endo-ekstralaringealnega nosilca igle, ki ga je razvil avtor in za široko proizvodnjo modificirala družba R. WOLF Ltd. iz Nemčije. Instrument se potiska naprej, dokler ni njegov distalni zaviti topi konec tipljiv v zgornji tretjini traheostome. Iglo z nitjo (2/0 prolen) se nato potiska od znotraj navzven v zgornji tretjini traheostome. Dvojno žico, ki tvori zanko, se vodi skozi koničast kovinski stožec z vgrajeno iglo in skozi kateter ter se jo priveže za obročkom, ki služi za fiksacijo z nasprotne strani. Vodilno nit iz 2/0 prolena se nato zavozla skupaj z žico. Z vlečenjem niti in žice nato koničasti konec kovinskega stožca perforira mehke dele in s sabo potegne kateter. Po tem postopku je govorno protezo mogoče enostavno namestiti v fistulo po običajnem načinu.
Deskriptorji		LARYNGECTOMY LARYNX, ARTIFICIAL VOICE SURGERY, ENDOSCOPIC LARYNGOSCOPY TRACHEOSTOMY LIDOCAINE INSUFFLATION