Our Summary

This research paper examines the issue of voice loss as a result of laryngectomy, a surgical operation to remove the larynx, often done in cases of throat cancer. The loss of voice is a significant concern for patients and a lot of effort has gone into finding ways to help patients regain their ability to speak and swallow after this surgery.

The researchers looked at historical medical documents as well as more recent publications, aiming to understand the various methods that have been used to rehabilitate speech and swallowing abilities.

They found four main categories of voice rehabilitation: external electrical devices, esophageal speech (a technique of swallowing air and releasing it to create sound), and tracheoesophageal shunts (a surgical procedure that redirects air flow from the trachea to the esophagus, enabling speech) either with or without the use of fistula valves/voice prostheses (devices that help produce sound).

Over the past 30 years, the use of fistula valves/voice prostheses has become the most preferred method. However, some patients still use esophageal speech or external devices as a backup method if the prosthesis fails.

FAQs

  1. What are the different categories of voice rehabilitation after laryngectomy?
  2. What is the current state-of-the-art method for voice rehabilitation post-laryngectomy?
  3. What other methods can be used for voice rehabilitation in case of prosthesis failure?

Doctor’s Tip

One helpful tip a doctor might give a patient after laryngectomy is to practice good oral hygiene to prevent infections around the stoma (opening in the neck). This includes regularly cleaning the area with a soft cloth or cotton swab and keeping the skin dry and free from irritation. Additionally, it is important to follow proper care instructions for any voice prosthesis or other devices used for speech rehabilitation. Regular follow-up appointments with a speech therapist and healthcare provider are also crucial for monitoring progress and addressing any issues that may arise.

Suitable For

Patients who are typically recommended for laryngectomy are those who have advanced laryngeal cancer, recurrent laryngeal cancer, or other conditions that affect the larynx and cannot be treated with other methods such as radiation therapy or chemotherapy. These patients may have difficulty breathing, swallowing, or speaking due to their condition, and a laryngectomy may be necessary in order to remove the affected tissue and improve their quality of life.

Timeline

  • Before laryngectomy: The patient may experience symptoms such as hoarseness, difficulty swallowing, or a persistent cough. They may undergo various tests and consultations with healthcare professionals to determine the need for a laryngectomy.

  • Laryngectomy surgery: The patient undergoes a surgical procedure to remove the larynx, which may also involve removal of surrounding structures such as the thyroid gland or lymph nodes. The patient will receive post-operative care and may stay in the hospital for a period of time to recover.

  • After laryngectomy: The patient will experience a loss of voice as a result of the surgery. They may undergo voice rehabilitation therapy to learn alternative methods of communication such as esophageal speech, the use of external (electrical) devices, or tracheoesophageal shunts with voice prostheses. The patient will also need to adjust to changes in swallowing and breathing patterns.

  • Long-term management: The patient will continue to receive follow-up care from healthcare professionals to monitor their progress and address any complications or issues that may arise. They will also need to adapt to lifestyle changes, such as avoiding certain foods or activities that may exacerbate their condition.

What to Ask Your Doctor

  1. What are the different options for voice rehabilitation after laryngectomy?
  2. What are the potential benefits and drawbacks of each type of voice rehabilitation?
  3. How long does it typically take to learn and become proficient in each type of voice rehabilitation?
  4. Are there any specific factors that may make one type of voice rehabilitation more suitable for me than another?
  5. What kind of ongoing care or maintenance is required for the chosen method of voice rehabilitation?
  6. What are the potential complications or risks associated with each type of voice rehabilitation?
  7. Are there any support groups or resources available for patients undergoing voice rehabilitation after laryngectomy?
  8. How often will follow-up appointments be needed to monitor progress and address any issues with voice rehabilitation?
  9. Are there any dietary or lifestyle changes that should be considered to support successful voice rehabilitation?
  10. What are the long-term outcomes and success rates for patients who undergo voice rehabilitation after laryngectomy?

Reference

Authors: Lorenz KJ. Journal: HNO. 2015 Oct;63(10):663-4, 666-80. doi: 10.1007/s00106-015-0043-4. PMID: 26403993