A comparison of various shunt methods for vocal rehabilitation

Since 1975. we have been trying out various shunt method procedures on laryngectomized patients due to the malignancy of their airway/digestive tracts. A total of 87 cases of shunt method procedures were performed. These included 42 cases of the modified Komorn method (MK), 27 cases of the simple mucodermal method (SMD), 10 cases of the omohyoid loop method (OH), four cases of the tracheo-gastric shunt (T-G), and four cases of the tracheo-jejunal shunt (T-J). MK, SMD and OH belong to the tracheo-esophageal shunt (T-E). The technical ease, phonetic data. aspiration and success rate of these cases were evaluated. The quality of voice obtained, using the esophageal mucosa, is significantly better than of that using the mucosa of digestive tract. This is due to the fact that the former forms a pseudo-glottic swelling on the mucosa. The success rates were 80% in MK. 81% in SMD. 90%. in OR 75% in T-G. and 100%, in T-J 3 months after surgery. However, it is interesting that most of the success rates were close to 70% 1 year after the surgery Although the aspiration problem still remains to be solved, the shunt voice is very important in maitaining a higher quality of life for alaryngeal patients.