“The goal is for her to find her former voice,” explains the surgeon coordinating the operation.

For now, Karine has found the smells again. His voice remains gravelly, while the larynx “reinserts itself, remobilizes itself, becomes resensitized”. Twelve surgeons worked around her for 27 hours, each with their own specialty.

“It’s almost just microsurgery. The elements that we connect are of the order of a few millimeters”, explains Tuesday November 21 on franceinfo Professor Philippe Céruse, head of the ENT and head and neck surgery department at the Croix-Rousse hospital, in Lyon. Two months ago, he coordinated the 12 surgeons who performed the larynx transplant on a patient, Karine, for 27 hours. A unique and successful operation in France, which could enable others to be carried out, the surgeon hopes.

franceinfo: How is Karine, your patient, two months after the operation?

Philippe Céruse: She was able to return home, she is doing well, despite two difficult months, it must be said. But she is back home, smiling again and she was able to reunite with her family and her daughters.

The operation took place over two days, we are talking about a composite graft, what does that mean?

The larynx is made of cartilage, muscles, mucous membranes, arteries and therefore it is composite, there are several tissues within this graft. It’s complicated because it’s an organ that is complex, due to its vascularization, its innervation and its role.

“The larynx is not only used for speaking, but also for eating and breathing. And so we have to be able to find these three functions and that’s what makes it so complex.”

Professor Philippe Céruse, head of the ENT and head and neck surgery department at Croix-Rousse hospital

at franceinfo

Is it much more complicated than a heart or lung transplant?

I’m not really going to say this because my colleagues would blame me, but let’s say it’s more thorough. It’s finer because it’s almost just microsurgery. The elements that are connected are of the order of a few millimeters, so there is a microsurgery time which is significant and which is long. This is why there were so many of us on this intervention.

There were 12 surgeons, does that mean 12 experts each in their field?

All of them, indeed, are among the best in head and neck surgery. We also had a thoracic surgeon, who helped us take the graft, because we start taking it from the thorax. We had Professor Badet, who is a urologist, but above all who coordinates this entire multidisciplinary team, to achieve a real transplant.

“It’s not just surgeons, there are also immunologists, nephrologists, etc…. All experts in their field.”

Professor Philippe Céruse

at franceinfo

Let’s talk a little about Karine. She still has a very cavernous, very gravelly voice. Can she really talk again?

Yes, the goal is that she manages to find her voice of yesteryear. Indeed, the voice you hear is a voice that is not the one you expect in several months, or even a year. Because the larynx is not yet functioning, it must reinervate itself, remobilize itself, resensitize itself, and therefore, this is not the voice she will have.

It’s a question of time, a question of rehabilitation. Will this also require a lot of effort?

It’s going to take time for the larynx to re-innerve itself, for the nerves to grow back, and then for rehabilitation, because she has forgotten how to speak. So we will have to coordinate all that, we will have to coordinate breathing, speech. It’s a long-term job and she will be helped with this by speech therapists.

Her speech therapist describes the moment when she felt for the first time air passing through her larynx, was it a sensation that she had forgotten?

Absolutely, and not only that, but she felt smells for the first time. Because we must not forget that when air passes through the nose, it is thanks to that that we have smells. She was very moved the day she felt smells for the first time.

There have only been four operations like this recorded since 1998. Are there going to be more in France?

There have only been four recorded, but there are many more. In fact, there are eleven in the world that have been made, but not all of them published. Yes, we hope there will be others, since we have the green light and the budget to do three. So we hope, when we know that the signals are green for the patient, that we can give the green light to continue with the other interventions.