In one of the most complex transplant surgeries ever performed, an international team of surgeons has restored the voice of a US woman who had been unable to speak for more than a decade.
The surgical team, including Professor Martin Birchall from University College London, replaced the larynx (voicebox), thyroid gland and trachea (windpipe) in a 52-year-old woman who had lost her ability to speak and breathe on her own.
The 18-hour operation, which took place over a two-day period in October 2010, is only the second documented case of its kind in the world. Just 13 days after the operation, Brenda Charett Jensen voiced her first words in 11 years and is now able to speak easily and at length.
She said: “This operation has restored my life. I feel so blessed to have been given this opportunity. It is a miracle. I’m talking, talking, talking, which just amazes my family and friends.” The only other documented larynx transplant took place at the Cleveland Clinic in 1998.
Professor Birchall said: “Despite decades of effort, patients with advanced laryngeal disease or injury have faced reconstructive procedures that are literally 150 years old. This transplant provides us with a much greater understanding about the viability of laryngotracheal transplantation and patient response, and it may prove to be a good option to help other people. This is an example of a highly innovative technology, done for the first time in man.”
Gregory Farwell, lead surgeon for the transplant, said: “We are absolutely delighted with the results of this extraordinary case.The larynx is an incredibly complex organ, with intricate nerves and muscles functioning to provide voice and allow breathing. Our success required that we assemble an exceptional, multi-disciplinary team, use the most recent advances in surgical and rehabilitation techniques, and find a patient who would relish the daunting challenges of undergoing the transplant and the work necessary to use her new voicebox.”
Prior to the transplant, Brenda was unable to speak or breathe normally because of complications stemming from a previous surgery several years ago that closed off her airway and made her completely dependent on a tracheotomy tube. For more than a decade, she has been limited to vocalising words using a handheld electronic device that produces an artificial, robot-like sound. In order to breathe, she has relied on the tracheotomy, which is still in place and visible at the base of her neck.
Brenda’s 18-hour procedure was followed by two months of rehabilitation. Her newly restored voice, while sounding hoarse at times, has improved significantly since the transplant as her nerves regenerate and she learns again how to speak. While the donor organ came from an accident victim, Brenda’s voice is her own and not that of the female donor. The transplant has allowed her to smell and taste for the first time in years. She is in the process of relearning to swallow and hopes to soon be able to eat and drink normally again.
The entire transplantation involved nearly two dozen doctors, nurses, technicians, transplant coordinators and other medical personnel.
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