BOSTON — The recipient of the first successful larynx transplant three years ago now speaks with a perfectly normal voice, and his surgeon says he is ready to perform the operation again.
Timothy Heidler, who spoke his first raspy "hello" three days after the operation, has continued to improve. He occasionally gives motivational speeches to patient and support groups.
The 1998 operation received considerable publicity. The surgical team updated the results in a report in Thursday's issue of the New England Journal of Medicine.
"Your voice is you. Now he has his back," said Dr. Marshall Strome of the Cleveland Clinic, the lead surgeon.
Heidler, of Duncansville, Pa., was 40 when he had the operation. He had been unable to speak normally for 20 years after his throat was crushed in a motorcycle accident.
Doctors searched for six months for a suitable donor and finally settled on a 40-year-old man who had died of a stroke.
Heidler has a deep voice and a hint of a Pennsylvania accent. He cannot remember his own voice from before the accident.
"We think I sound like my dad," he said. "I know I don't sound anything like the donor's voice. I've heard tapes of him and talked to his stepmother and dad."
Doctors replaced Heidler's larynx, or voice box, along with part of his trachea, throat and nerves. Because they didn't want to disrupt the larynx's blood supply, they also transplanted the nearby thyroid and parathyroid glands, too. The patient now has two thyroid glands, both of which appear to work, as well as eight parathyroid glands.
One unknown was whether he would be able to swallow. For three months, Heidler could not. But he began to regain sensation as the nerves grew together, and within a month he could eat everything.
Heidler said he began talking regularly about the same time. "It took a good year and a half until I didn't sound raspy," he said. "But any voice is better than no voice."
Strome said he hopes next to perform the operation on someone whose voice box has been removed because of cancer and has survived disease-free at least five years. Such an operation may be even more challenging, because it could be difficult to locate the ends of nerves that were cut during the cancer surgery.
Transplant surgeon Anthony Monaco of Harvard Medical School had his own larynx removed seven years ago for cancer. At the time, he doubted that such a transplant would be possible any time soon.
"Strome and colleagues have proved my prediction to be pleasantly incorrect," he wrote in a journal editorial. Despite the need to take immune suppressing drugs, "if I were 40 years old, I would probably consider undergoing the operation myself."
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