Donna S Lundy

University of Miami, كورال غيبلز، فلوريدا, Florida, United States

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Publications (2)3.71 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: Objective: To describe the speech rehabilitation outcomes of patients undergoing total laryngectomy (TL) in the 21st century.Study Design: Retrospective chart review.Setting: Tertiary academic centerSubjects and Methods: Retrospective review of 167 patients who underwent TL from June 2000 to February 2012. Demographics, disease variables, and surgical factors were reviewed. Primary alaryngeal speech modality, speech outcome, and TEP complication rates were assessed.Results: Overall TEP speech success rate (primary or secondary) was 72%; overall TEP speech success rate for those with primary TEP was 76% and for secondary TEP was 68%. TEP speech success rates at 1st, 2nd, and beyond 2nd year were 75%, 72%, and 70%, respectively. Success rates for primary TL, salvage TL, primary TL with pharyngeal reconstruction, or salvage TL with pharyngeal reconstruction groups were 71%, 72%, 73%, and 71%, respectively. TEP-related complications occurred in 43% of patients, with no difference in complication rates between primary versus salvage TL or primary versus secondary TEP. Of those with complications, TEP success rate was 65%.Conclusion: This study showed TEP speech outcome success rates lower than what has been historically reported. There was no significant difference in TEP speech outcome between primary versus salvage TL or primary versus secondary TEP. Patients with TEP-related complications had TEP speech outcome success rates comparable to those without any complication. TEP may continue to be a superior option as a mode of speech in patients with TL including those undergoing salvage TL.
    The Laryngoscope 04/2014; · 1.98 Impact Factor
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    ABSTRACT: Objective The purpose of this study is to investigate prosthesis size stability over time and determine which factors influence need for change in size. Study Design Retrospective chart review. Setting Teaching hospital. Subjects and Methods Retrospective chart review was performed on all individuals who had previously undergone total laryngectomy and tracheoesophageal puncture and had a minimum of 3 years of consistent and consecutive follow-up data after their prosthesis was initially placed. Data reviewed included demographic variables of age at time of tracheoesophageal puncture, ethnicity, and sex. Results Fifty patients were identified who met criteria for study inclusion with a mean age of 64.7 years (range, 43-86 years) with 41 (82%) men and 9 (18%) women. Surgical management was equally divided between those who underwent total laryngectomy (n = 25) as primary treatment vs those who had salvage laryngectomy (n = 25) for persistent or recurrent disease. Prosthesis size was stable, with no change in diameter or length, in only 5 (10%) patients and unstable in 45 (90%), as they were changed at least once. The only factor that demonstrated statistical significance was sex (Fisher exact test = 0.035), with women being more likely to have a stable prosthesis size over time. Conclusions The results of this study demonstrate that 90% of patients who underwent total laryngectomy and tracheoesophageal puncture required a change in their prosthesis size beyond the first 3 months of expected healing. These results support the need for continual reassessment of the fistula tract when changing the prosthesis to ensure appropriate fit.
    Otolaryngology Head and Neck Surgery 05/2012; 147(5):885-8. · 1.73 Impact Factor

Publication Stats

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3.71 Total Impact Points

Institutions

  • 2014
    • University of Miami
      كورال غيبلز، فلوريدا, Florida, United States
  • 2012
    • University of Miami Miller School of Medicine
      • Department of Otolaryngology
      Miami, FL, United States