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Primary tracheoesophageal puncture vs esophageal speech
M Quer1, J Burgués-Vila, P García-Crespillo
1Otorhinolaryngology Service, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma, Barcelona, Spain.
Archives of Otolaryngology--Head & Neck Surgery
|February 1, 1992
Summary
Tracheoesophageal voice prosthesis offers immediate speech after laryngectomy, but most patients prefer esophageal speech long-term. One-third of patients successfully use the prosthesis for daily communication.
Area of Science:
- Otolaryngology
- Speech-Language Pathology
- Rehabilitation Medicine
Background:
- Total laryngectomy necessitates alaryngeal voice restoration.
- Tracheoesophageal puncture (TEP) with prosthesis and esophageal speech (ES) are primary methods.
- Patient choice and long-term adherence influence method selection.
Purpose of the Study:
- To evaluate the cost-efficiency and patient preference for TEP voice versus ES in alaryngeal patients.
- To compare the functional outcomes and patient satisfaction between TEP and ES.
Main Methods:
- Prospective study of 28 patients undergoing total laryngectomy with primary TEP.
- Patients received instruction in both TEP and ES, with the option to switch.
- Phonation success with prosthesis and long-term voice use were assessed.
Main Results:
- 23 patients completed the study; 70% (16/23) preferred ES despite TEP's superior voice quality.
- 30% (7/23) exclusively used TEP for communication.
- TEP provided immediate postoperative voice, aiding psychological and practical adjustment.
Conclusions:
- Primary TEP offers significant psychological and practical benefits, providing an immediate voice post-laryngectomy.
- While TEP is effective for some, ES remains the preferred alaryngeal voice method in this region for those who master it.
- A substantial minority of patients benefit from and continue TEP use for daily communication.