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Leighnette L Geronimo
Philippine Academy of Laryngology and Phoniatrics, PhilippinesTitle: A long-term eighteen-year evaluation of voice production and aspiration of patients who underwent total laryngectomy with ureta primary voice reconstruction
Abstract
Among malignant neoplasm, head and neck cancers ranks 6th most common
malignancy in the Philippines and laryngeal carcinoma is the 14th cause of
cancer deaths in males. Interestingly, cigarette smoking is the principal
culprit of this health dilemma. Total laryngectomy with post-operative
indication is the mainstay of treatment for advanced laryngeal cancer. Despite
of a good prognosis after total laryngectomy, total surgical removal of the
larynx essentially requires a permanent tracheostoma, which in effect disabling
voice production and affecting swallowing mechanism. In our institution, an
improvement of the Amatsu TEF technique was developed. It is a modification of
Amatsu Technique, which successfully produced voice and minimized the incidence
of aspiration. This is known as the Ureta Primary Voice Reconstruction
Technique without the use of prosthesis. The study used a cross-sectional
survey which was done in a tertiary hospital involving 57 males with ages
ranging from 47-87y/o. The subjects had Stage III and IV laryngeal SCCA who
underwent total laryngectomy with Ureta primary voice reconstruction, with neck
dissection and completed post-operative radiotherapy from 1995 up to October
2013. With proper consent, the subjects were asked to answer the
validated Philippine Post-Laryngectomy Questionnaire.
The results showed that all participants acquired voice with 94.7%
effective conversational speech and only 1.8% prevalence of severe aspiration.
All patients without to milder degree of aspiration acquired an efficient,
understandable, and conversational voice. A significant relationship between
degree of aspiration and onset of voice acquisitions post-operatively was also
evident wherein patients without aspiration acquired voice earlier as 2 weeks
post-operatively. The degree of aspiration versus number of spoken words per
breath showed that all patients without aspiration to milder degree of
aspiration can speak. Patients without aspiration, have efficient voice
production, produce voice immediately, and can easily verbalize understandable
words like a normal person.
Biography
Leighnette Geronimo, MD is a
graduate of Doctor of Medicine from University of the East Ramon Magsaysay
Memorial Medical Center. She trained at Veterans Memorial Medical Center in the
Philippines at the department of otorhinolaryngology head and neck surgery during
her residency. She was able to provide superior care and consultation alongside
with presenting research papers locally and internationally. Afterwards, she
completed a fellowship in laryngology at Hiroshiba ENT Surgicenter, Kyoto,
Japan. She is also a board-certified specialist of Philippine Board of Otolaryngology
Head and Neck Surgery and an associate member of Philippine Association of
Laryngology and Phoniatrics.
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