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Related Concept Videos

Larynx01:21

Larynx

The human larynx, often referred to as the voice box, is an intricate organ located in the neck. It serves as a pathway for air to enter the lungs during respiration and is an essential component of voice production.
Anatomy of the Larynx
The larynx consists of various components, including cartilage, muscles, and vocal cords. Its structure includes three large unpaired cartilages—the thyroid, cricoid, and epiglottis—and three smaller paired cartilages—the arytenoids, corniculates, and...
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...
Tracheostomy Suctioning I: Pre-Procedural Steps01:26

Tracheostomy Suctioning I: Pre-Procedural Steps

Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Oxygen Delivering System III: Tracheostomy and T-piece01:23

Oxygen Delivering System III: Tracheostomy and T-piece

Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...

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Updated: May 17, 2026

Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
07:45

Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing

Published on: December 1, 2023

Managing Voice-Related Issues in Laryngectomized Patients With Voice Prosthesis: A Troubleshooting Algorithm for

Ylenia Longobardi1, Claudio Parrilla2, Ilaria Proietti1

  • 1Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia.

Journal of Voice : Official Journal of the Voice Foundation
|May 15, 2026
PubMed
Summary

Voice prosthesis (VP) complications after total laryngectomy (TL) affect over half of patients, with hypertonic voice being most common. Targeted voice therapy (VT) effectively manages these issues, achieving high resolution rates for most voice-related problems in TE voice users.

Keywords:
Patient-reported outcome measures (PROMs)Total laryngectomyTracheoesophageal voiceVoice prosthesisVoice therapy

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Area of Science:

  • Otolaryngology
  • Speech-Language Pathology
  • Oncology Rehabilitation

Background:

  • Total laryngectomy (TL) with voice prosthesis (VP) placement is a common treatment for advanced laryngeal cancer.
  • Post-surgical voice-related issues are prevalent, impacting communication and quality of life for laryngectomized patients.
  • Voice therapy (VT) is a crucial component of rehabilitation for tracheoesophageal (TE) voice restoration.

Purpose of the Study:

  • To analyze the spectrum of voice-related issues encountered in patients using a voice prosthesis after total laryngectomy.
  • To evaluate the efficacy of voice therapy in managing these voice-related complications.
  • To identify factors influencing the success of voice therapy for TE voice.

Main Methods:

  • Retrospective analysis of 194 patients who underwent total laryngectomy (TL) with voice prosthesis (VP) placement and subsequent voice therapy (VT).
  • Patients were categorized by vocal symptoms and underlying causes.
  • Outcomes were assessed using patient-reported outcome measures (PROMs) including I-SECEL, UWQoL-v4, and the INFVo scale, alongside auditory-perceptual assessments.

Main Results:

  • Over half of patients (51.55%) experienced voice-related issues, with hypertonic voice being the most frequent (40%).
  • Voice therapy (VT) achieved a 72% resolution rate for hypertonic voice, increasing to 95% with botulinum toxin injections.
  • Specific VT protocols led to an overall resolution rate of 92% in treated cases, with a 95% success rate in the entire cohort.

Conclusions:

  • Identifying specific voice-related issues through patient assessment is key for effective, targeted voice therapy in TE voice users.
  • Voice therapy demonstrates high success rates in managing a wide range of voice complications post-laryngectomy.
  • Personalized VT strategies contribute significantly to successful voice restoration and improved communication after TL.