[The clinical presuppositions and results of logopedic therapy]

Logopedic therapy is proposed in helping cordectomized patients learn to best use pneumo-phonal structures to compensate for the glottic insufficiency often resulting from this type of surgery. Rehabilitation showed be initiated as soon as possible following surgery before the patients starts using compensation mechanisms negative for voice quality. However, precisely those patients often receive therapy tardively when the anatomo-functional results have already been consolidated and the voice quality is poor. The rehabilitation discussed uses classical feed back mechanisms through which the subjects learn to recognise those factors which enable them to better their voice quality. The type of exercises to be employed depends on whether or cordectomy extended to the ventricle and to false vocal cord. On the farmer case, the principle aim of therapy is that of nearing the healthy vocal cord to the neocord through appropriate exercises. On the better case, instead, the main vocal compensation is the result of the perfect coordination of expiratory energy and the activity of the healthy vocal cord. In fact, in extended cordectomized patients, in the light of the modest amount of scarring, it is necessary to cause the healty voice cord to shift entirely towards and beyond the median line as to as compensate for a sphincteric loss. The authors report two clinical case, particularly difficult from a rehabilitation point of view, in which, relatively speaking, in light of the initial voice conditions, satisfactory results were obtained.