A novel surgical procedure allows Sherry
Wittenberg - a cancer patient to keep her voice.
The technique, detailed online ahead of print
publication in The Laryngoscope, reconstructs a ring of cartilage in a
patient's neck called the cricoid with a slice from the tip of one shoulder
The biggest challenge is that doctors have never
been able to rebuild a cricoid cartilage so that the patient can breathe
through it, says Chepeha, director of microvascular surgery in the Department
of Otolaryngology, Head and Neck Surgery, at the U-M Medical School. The
reconstruction has to be both strong and thin - it has to hold the larynx and
the components of the larynx together, and still be open so that the patient
can breathe through it.
The curved tip of a patient's scapula, or
shoulder blade, provides the right combination of attributes, Chepeha explains.
And the blood vessels feeding the scapula tissue are left intact.
We had to carve this piece of her shoulder a
little bit and then put it in her airway, he says. When you do a transplant
from one part of the patient's body to another, you don't have the risk of
rejection you would have with an outside donor.
A graft of tissue from the inside of Wittenberg's
mouth was used to help reconstruct the lining of her larynx.
We had to pay a great deal of attention to the
muscles and cartilage that were attached to the cricoid, Chepeha says. We had
to carefully detach them, check that we had adequately removed the tumor, and
then, once the scapular tip was in position, we had to reattach the muscles and
Within just three months, Sherry was able to
return to work, her voice intact and her larynx cancer-free.
My greatest fear was that I wouldn't be able to
talk again, to work again, says Wittenberg, 58, of Cement City, Mich. My
husband is a dairy farmer and farming's been very rough these days. I knew we
needed my job.
Today, Wittenberg says her breathing has returned
to normal and her speech is very close to what it was before the operation.
The only difference is that my voice doesn't have
quite the same volume it did before, she says.
I feel like it was a miracle, Wittenberg adds. I
happened to be in the right place with the right surgeon at the right time who
was willing to try something that had never been done.