Disclaimer: The information contained within the Grand Rounds Archive is intended for use by doctors and other health care professionals. These documents were prepared by resident physicians for presentation and discussion at a conference held at Baylor College of Medicine in Houston, Texas. No guarantees are made with respect to accuracy or timeliness of this material. This material should not be used as a basis for treatment decisions, and is not a substitute for professional consultation and/or peer-reviewed medical literature.

Laryngeal Transplantation
Brian H. Weeks, M.D.
July 23, 1998

A 56-year-old male was seen in the VA Tumor Clinic for routine checkup. The patient had undergone a total laryngectomy for a T3N0 SCCA of the larynx in 1995. At that time, the patient experienced an uneventful post-operative course and no complications. He underwent speech rehabilitation and chose to use an electrolarynx for his post-operative phonation.

The patient's past medical history is significant for hypertension, coronary artery disease, and gout. He has a long history of tobacco and alcohol use, and is currently smoking 2 packs of cigarettes per day. On examination, the patient is afebrile. His blood pressure is mildly elevated with room air saturation of 95%. He has a well-healed tracheostome with no evidence of recurrent disease. On auscultation, his lungs have scattered rhonchic bilaterally. Cardiac exam revealed a regular rate and rhythm with a grade II/VI systolic ejection murmur. On chest X-ray, he has emphysematous changes with no masses or suspicious lesions. His routine lab work is within normal limits.

The patient states that he had recently read somewhere about alternative forms of natural speech for post-laryngectomy patients and he wondered what options were available to him. The patient is told he could possibly be a candidate for a tracheoesophageal puncture and a speech therapy referral is made. The patient is scheduled for a follow-up visit in the ENT clinic.

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Last modified: January 9, 2006