Abstract：
BACKGROUND: The loss of laryngeal function affects breathing, swallowing, and voice, thus severely compromises quality of life. Laryngeal transplantation has long been suggested as a solution for selected highly affected patients with complete laryngeal function loss.
OBJECTIVE: To obtain insights regarding the advantages, weaknesses, and limitations of this procedure and facilitate future advances, we collected uniform data from all known laryngeal transplants reported internationally.
METHODS: A case series. Patients were enrolled retrospectively by each institutional hospital or clinic. Eleven patients with complete loss of laryngeal function undergoing total laryngeal transplantation between 1998 and 2018 were recruited.
RESULTS: After a minimum of 24 months follow-up, three patients had died (27%), and there were two graft explants in survivors, one total and one partial, due to chronic rejection. In the remaining cases, voice was functional in 62.5% and 50% achieved decannulation. Swallowing was initially restricted, but only one patient was gastrostomy-dependent by 6 months and all had normal or near-normal swallowing by the end of year two after transplantation. Median follow-up was 73 months. Functional (voice, swallowing, airway) recovery peaked between 12 and 24 months.
CONCLUSIONS: Laryngeal transplantation is a complex procedure with significant morbidity. Significant improvements in quality of life are possible for highly selected individuals with end-stage laryngeal disorders, including laryngeal neoplasia, but further technical and pharmacological developments are required if the technique is to be more widely applicable. An international registry should be created to provide better quality pooled data for analysis of outcomes of any future laryngeal transplants.
METHODS: IV Laryngoscope, 2024.
OBJECTIVE: To obtain insights regarding the advantages, weaknesses, and limitations of this procedure and facilitate future advances, we collected uniform data from all known laryngeal transplants reported internationally.
METHODS: A case series. Patients were enrolled retrospectively by each institutional hospital or clinic. Eleven patients with complete loss of laryngeal function undergoing total laryngeal transplantation between 1998 and 2018 were recruited.
RESULTS: After a minimum of 24 months follow-up, three patients had died (27%), and there were two graft explants in survivors, one total and one partial, due to chronic rejection. In the remaining cases, voice was functional in 62.5% and 50% achieved decannulation. Swallowing was initially restricted, but only one patient was gastrostomy-dependent by 6 months and all had normal or near-normal swallowing by the end of year two after transplantation. Median follow-up was 73 months. Functional (voice, swallowing, airway) recovery peaked between 12 and 24 months.
CONCLUSIONS: Laryngeal transplantation is a complex procedure with significant morbidity. Significant improvements in quality of life are possible for highly selected individuals with end-stage laryngeal disorders, including laryngeal neoplasia, but further technical and pharmacological developments are required if the technique is to be more widely applicable. An international registry should be created to provide better quality pooled data for analysis of outcomes of any future laryngeal transplants.
METHODS: IV Laryngoscope, 2024.
摘要：
背景：喉功能的丧失影响呼吸，吞咽,和声音，从而严重影响生活质量。长期以来，人们一直建议将喉移植作为选择严重影响喉功能完全丧失的患者的解决方案。
目标：为了获得有关优势的见解，弱点,和这一程序的局限性，并促进未来的进步，我们收集了国际上报道的所有已知喉移植的统一数据.
方法：案例系列。患者由每个机构医院或诊所回顾性登记。招募了1998年至2018年间接受全喉移植的11例喉功能完全丧失的患者。
结果：经过至少24个月的随访，三名患者死亡(27%)，幸存者中有两个移植外植体，一个全部和一个部分，由于慢性排斥反应。在其余案件中,声音在62.5%和50%实现了脱管时是功能性的。最初限制吞咽，但只有1例患者在6个月时依赖胃造口术,且在移植后2年结束时吞咽正常或接近正常.中位随访时间为73个月。功能(语音，吞咽,气道）恢复在12到24个月之间达到峰值。
结论：喉移植是一个复杂的手术，发病率很高。对于高度选择的终末期喉部疾病患者，生活质量有可能得到显着改善，包括喉瘤,但是，如果该技术要更广泛地应用，还需要进一步的技术和药理学发展。应建立国际注册中心，以提供更高质量的汇总数据，以分析未来任何喉部移植的结果。
方法：IV喉镜，2024.
目标：为了获得有关优势的见解，弱点,和这一程序的局限性，并促进未来的进步，我们收集了国际上报道的所有已知喉移植的统一数据.
方法：案例系列。患者由每个机构医院或诊所回顾性登记。招募了1998年至2018年间接受全喉移植的11例喉功能完全丧失的患者。
结果：经过至少24个月的随访，三名患者死亡(27%)，幸存者中有两个移植外植体，一个全部和一个部分，由于慢性排斥反应。在其余案件中,声音在62.5%和50%实现了脱管时是功能性的。最初限制吞咽，但只有1例患者在6个月时依赖胃造口术,且在移植后2年结束时吞咽正常或接近正常.中位随访时间为73个月。功能(语音，吞咽,气道）恢复在12到24个月之间达到峰值。
结论：喉移植是一个复杂的手术，发病率很高。对于高度选择的终末期喉部疾病患者，生活质量有可能得到显着改善，包括喉瘤,但是，如果该技术要更广泛地应用，还需要进一步的技术和药理学发展。应建立国际注册中心，以提供更高质量的汇总数据，以分析未来任何喉部移植的结果。
方法：IV喉镜，2024.
