VIDEORADIOGRAPHY OF FREE JEJUNAL GRAFTS FOR REHABILITATION OF SPEECH IN LARYNGECTOMIZED PATIENTS

In laryngectomized patients a tracheo-esophageal artificial fistula ca n be used to achieve air flow from the trachea to the esophagus during speech. A one-way plastic valve is often used for the fistula. A free jejunal graft between the trachea and the esophagus can also be used. To avoid aspiration the transplant is attached to the submental area giving the graft a siphon-like shape. We performed 23 videoradiographi c examinations using high-density barium in 14 such patients. The aim was to evaluate the protective function of these grafts against aspira tion. Penetration of the bolus and a small amount of residual contrast material in the ascending limb of the graft was a normal finding. If the standard barium bolus reached the descending limb at any time duri ng the examination, this was a sign of aspiration hazard. To avoid asp iration, the vertex of the speech siphon should be higher than the lev el of the hypopharyngeal anastomosis.