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Postlaryngectomy voice restoration--a 2-year review
R Lentin1, G Williams, S L Sellars
1Department of Logopaedics, Groote Schuur Hospital, Cape Town.
Summary
Tracheoesophageal speech using a voicing prosthesis after total laryngectomy is effective for most patients. However, about one-third experience speech loss due to psychological and socioeconomic factors.
Area of Science:
- Otolaryngology
- Speech-Language Pathology
Background:
- Total laryngectomy necessitates alternative methods for voice restoration.
- Tracheoesophageal speech with a prosthesis is a common post-laryngectomy voice rehabilitation technique.
Purpose of the Study:
- To review the outcomes of tracheoesophageal speech using a voicing prosthesis after total laryngectomy.
- To identify factors influencing the success and failure of fistula speech.
Main Methods:
- A 2-year review of patients undergoing total laryngectomy with tracheoesophageal fistula formation and prosthesis use.
- Analysis of patient selection, surgical techniques, and postoperative management.
Main Results:
- Initially, 86% of patients achieved intelligible, fluent tracheoesophageal voice.
- Approximately one-third of patients lost their fistula speech within 2-3 months post-surgery.
- Psychological and socioeconomic factors were primary reasons for speech loss.
Conclusions:
- Tracheoesophageal speech with a prosthesis is a viable option for voice restoration post-laryngectomy.
- Successful outcomes depend on a multidisciplinary team approach and addressing patient-specific challenges.
- Primary healthcare workers require education on managing post-laryngectomy prosthetic speech.