By Yann Rivallan
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It is a first in France ! And only the fourth time in the world that such a surgical operation has been carried out. Between Saturday September 2 and Sunday September 3, 2023, a 49-year-old woman received a larynx transplant at the Croix-Rousse hospital in Lyon (Rhône).
A surgeon from Rouen University Hospital (Seine-Maritime), Professor Jean-Paul Marie, participated in this feat.
A 27-hour operation
Overall, this “extremely complex” operation lasted almost 27 hoursannounces a press release from the Hospices Civils de Lyon (HCL).
First of all, it was necessary to take the larynx of a donor with “an immunological match and a suitable size”, specifies Professor Marie.
Clearly, for the transplant to work, a healthy organ must be found, which corresponds to the recipient’s body and the size of his defective organ. It is therefore necessary to carry out a transplant “from a woman to a woman or from a man to a man”, adds the ENT professor and head and neck surgeon in Rouen.
“Laryngeal reinnervation”, an essential technique
In this intervention, Jean-Paul Marie was consulted in his capacity as an expert in nerve grafting, and more particularly in “laryngeal reinnervation”. For around thirty years, the professor has been working on this technique which consists, quite simply, of restore nerve connections to the larynx and vocal cords.
Without this technique, the transplanted larynx risks “not being functional”, adds the ENT professor from Rouen. It is therefore for this purpose that we called on him.
I was there initially to advise on larynx sampling and preparation techniques.
And then, the surgeon participated in “connecting the nerves” to the patient’s new larynx.
In total, a team of fourteen people coming from Lyon, Paris, Rennes, Nantes, Toulouse or Rouen (not counting around fifty professionals from the Lyon University Hospital such as nursing assistants or anesthesiologists) participated in the intervention.
A definitive result in “6 to 9 months”
The Hospices Civils de Lyon revealed a first conclusive result on Monday, November 20 during a press conference. Two months after the operation, Karine, 49, is doing well. And despite the beginnings of rejection of the transplant, which has since stopped, and a long hospitalization, it gradually begins to find your voice.
After a cardiac arrest in 1996, complications linked to her intubation in intensive care caused her to develop laryngeal stenosis. “Over the years, the latter had ended up completely deteriorating,” adds the HCL press release. For around twenty years, Karine had only breathed through a tracheotomy, without the possibility of speaking.
Today, she carries out weekly vocal cord rehabilitation (but also
swallowing and breathing), hoping to be able to regain a clear voice. But we will have to “wait another 6 to 9 months” to be completely sure, confides Professor Marie.
Only then can we say whether the operation is 100% successful. In the meantime, this great French first will perhaps open the way to other operations of this kind. And allow people who have lost their speech to find it again.
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