P. Pokieser et al., VIDEORADIOGRAPHY OF FREE JEJUNAL GRAFTS FOR REHABILITATION OF SPEECH IN LARYNGECTOMIZED PATIENTS, Acta radiologica, 36(5), 1995, pp. 469-473
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.