Man With Transplanted Voice Box Speaking Again

B O S T O N, May 31, 2001 -- Twenty years ago, Timothy Heidler was in a motorcycle accident that left him unable to speak. But the first successful larynx surgery in the United States has restored his voice.

"People love to talk to me now, I mean they understand me, they always say, 'boy your voice sounds so good,'" Heidler said. "Communication is the key to everything, without communication your life does not work."

He sometimes gives motivational speeches to patients and support groups.

The successful larynx transplant was the first in the United States, and was actually completed three years ago. Although his voice was raspy at first, Heidler's voice has gradually become normal. A study detailing the surgery's success is being published in the New England Journal of Medicine.

Could Help Cancer Patients

And ABCNEWS' Dr. Tim Johnson said that success is good news for thousands of people without voice boxes who might be able to benefit from the same operation.

"There are several thousand a year in this country alone, whohave to have the voice box removed because of cancer," Johnson said. "They are going to be looking for this operation as a new possibility."

The operation on Heidler was the first of its kind, and it was somewhat controversial because he faced all the risks of a major surgery for what is considered a non-vital organ.

There was a failed attempt to do a voice box transplant about 30 years ago, Johnson said. The operation was performed on a Belgian patient.

Heidler’s Hazardous Shortcut

But it's been a long road for Heidler, a former firefighter who used to love to ride his motorcycle while growing up in Altoona, Pa. One day in 1978, he was taking a shortcut down a road, where unknown to him, a cable had been hung between two trees to discourage cyclists. It caught him across the throat, destroying his voice box.

For the next 20 years, the only way he could make sounds was to use a tone- producing device that he manipulated with is lips and tongue to form words.

"I spent two years in the hospital and not being able to communicate is very frustrating," Heidler said.

During those same years, Dr. Marshall Strome, chief of otolaryngology at the Cleveland Clinic had been researching the transplantation of vocal cords into someone like Heidler who had lost their own voice from trauma or disease.

Doctor and patient came together in January 1998 in a 12-hour operation. Heidler became the first American patient ever to receive a voice box from a donor. It came from a man in Cincinnati who had died suddenly when a blood vessel ruptured in his brain.

A New Voice

The doctors replaced his larynx or voice box, along with part of his trachea, throat and nerves. To avoid disrupting the larynx's blood supply, doctors also transplanted the nearby thyroid and parathyroid glands as well.

"It's a fairly difficult operation, technically," Johnson said. "But the more difficult part, frankly, is the continuing risk of infection."

To stave off the risk of organ rejection, transplant patients must take immunosuppressant drugs for the rest of their lives. And those powerful drugs can cause liver and kidney damage, and can lead to cancer.

Three days after his pioneering surgery, Heidler faced the first big test. Strome covered the tracheotomy hole in his neck so he could try to speak the way most people do — by pushing air out of his lungs and up through his new vocal cords, causing them to vibrate into human sounds.

His first words were simple: first "hello," and then "hi, Mom."It was early, but promising, Strome said.

It took about three months before Heidler was able to swallow. He had to wait to regain sensation while the nerves grew together, but within a month he could eat anything.

It's now been three years since Heidler's amazing surgical procedure. He must still cover a hole in his throat with his thumb in order to speak. The doctors have not sealed the hole out of concern that something could go wrong after the groundbreaking surgery, but Heidler is doing really well and doctors do plan to seal it.

Strome told the Associated Press that he hopes next to perform the operation on someone whose voice box has been removed because of cancer and who has survived disease-free for at least five years.