MICROVASCULAR SMALL BOWL TRANSPLANTATION FOR THE RECONSTRUCTION OF VOICE AND SWALLOWING AFTER TOTAL LARYNGOPHARYNGECTOMY

After surgery of advanced larynx and pharynx malignancies, a main prob lem is reconstruction of swallowing and voice. With microvascular smal l bowl transplantation, we have been able to use a 30 cm segment of je junum in a one-stage procedure to reconstruct extended defects of the oropharynx, and total by hypopharynx, as well as to create a speaking- syphon as devised by Ehrenberger. The surgical technique is described and we now report the results achieved in our first five patients. Thi s new method enables pharyngectomized and laryngectomized patients to speak and to eat without any aspiration after about two weeks. This ra pid and functionally encouraging rehabilitation means a significant im provement in a patient's quality of life and is further justification for the great effort required in using this method.