Is myotomy necessary in all laryngectomies?

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From the Research

Myotomy in Laryngectomies

  • The necessity of myotomy in all laryngectomies is not universally established, as studies suggest it may be beneficial in certain cases, but not all 1, 2, 3, 4, 5.
  • Cricopharyngeal myotomy has been shown to reduce pharyngoesophageal spasm and facilitate vocal rehabilitation and tracheoesophageal speech in post-laryngectomy patients 2, 4.
  • Studies have reported improved speech outcomes with myotomy, including increased rates of functional tracheoesophageal speech 2, 5.
  • Myotomy may also help minimize postoperative fistulization and eliminate dysphagia of cricopharyngeus spasm 4.
  • However, myotomy is not without complications, and careful patient selection and education are necessary to manage expectations and outcomes 2, 5.

Indications for Myotomy

  • Myotomy may be indicated in cases where pharyngoesophageal spasm is a significant concern, or where vocal rehabilitation is a priority 2, 4.
  • Cricopharyngeal myotomy has been associated with improved postoperative voice in patients undergoing total laryngectomy for the dysfunctional larynx 5.
  • The decision to perform myotomy should be made on a case-by-case basis, taking into account individual patient needs and circumstances 1, 3.

References

Research

Secondary pharyngeal myotomy for tracheoesophageal speech.

Ear, nose, & throat journal, 1995

Research

Speech and swallowing outcomes after laryngectomy for the dysfunctional irradiated larynx.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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