Our Summary

In Germany, about 950-1200 people have their voice boxes (larynxes) removed each year due to serious throat and voice box cancer. This major surgery can dramatically change a person’s life as they lose their ability to speak and communicate as they used to. This can lead to mental health problems and social isolation.

To help these people get back to their everyday lives, a team of different healthcare professionals work together to help them regain their ability to communicate. There are several methods to do this. One method is “pseudowhispering,” which uses air from the mouth and throat. Another is “esophageal speech,” which involves controlling the release of air from the esophagus to create sound.

There are also external devices like the Electrolarynx, and a method called “tracheoesophageal speech,” which uses a prosthesis, or artificial part, in the throat. This method is currently the best one available, as it provides the most natural-sounding speech and longest speaking time. However, it does require regular hospital visits to deal with any complications and to replace the prosthesis, which doesn’t last forever.

Even though the tracheoesophageal prosthesis works well for many people, some might still face significant challenges. To conclude, helping people regain their ability to speak after voice box removal is crucial for helping them reintegrate into society. It’s important to fully educate patients about the benefits and challenges of each method so that they can make an informed decision that suits their lifestyle.

FAQs

  1. How many laryngectomies are performed annually in Germany due to extensive hypopharyngeal and laryngeal carcinomas?
  2. What are the different methods used for voice rehabilitation post-laryngectomy?
  3. What are the benefits and challenges of using tracheoesophageal speech prostheses for voice rehabilitation after a laryngectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laryngectomy is to be patient and persistent with the rehabilitation process. Learning to communicate effectively after a laryngectomy takes time and practice, so it’s important to stay positive and keep working with your healthcare team to find the best method for you. Don’t be afraid to ask for help or try different techniques until you find what works best for you. Remember, you are not alone in this journey and there are resources available to support you every step of the way.

Suitable For

Patients who are typically recommended for laryngectomy are those with extensive hypopharyngeal and laryngeal carcinomas that cannot be treated with other methods. These patients may have tried other treatments such as radiation therapy or chemotherapy without success, or their cancer may be too advanced for these treatments to be effective. Laryngectomy may also be recommended for patients with other conditions that affect the larynx, such as severe laryngeal trauma or chronic laryngeal stenosis.

Overall, laryngectomy is recommended for patients who have a high likelihood of benefiting from the procedure in terms of improving their quality of life and prognosis. It is important for patients to be fully informed about the potential risks and benefits of laryngectomy, as well as the potential impact on their ability to communicate and function in daily life.

Timeline

Before a laryngectomy:

  • Patients may experience symptoms such as hoarseness, difficulty swallowing, persistent cough, or a lump in the throat
  • Patients undergo diagnostic tests such as imaging scans and biopsies to confirm the presence of cancer
  • Treatment options such as surgery, radiation therapy, and chemotherapy are discussed with the patient
  • Preoperative counseling and education are provided to prepare the patient for the surgery and its potential impact on their life

After a laryngectomy:

  • Patients undergo surgery to remove the larynx, resulting in the loss of voice and the need for alternative methods of communication
  • Patients may experience temporary or permanent changes in their ability to swallow and breathe
  • Voice rehabilitation begins with the help of a multidisciplinary team, including speech therapists, otolaryngologists, and psychologists
  • Patients learn techniques such as pseudowhispering, esophageal speech, and the use of external aids or tracheoesophageal speech prostheses to communicate
  • Regular follow-up visits are scheduled to monitor the patient’s progress and address any complications or challenges that may arise
  • Patients may experience psychological and social challenges as they adjust to their new way of communicating and navigate life post-laryngectomy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laryngectomy include:

  1. What are the potential risks and complications of laryngectomy surgery?
  2. What are the different methods of voice rehabilitation available after laryngectomy?
  3. How do these different methods of voice rehabilitation work and what are the pros and cons of each?
  4. What can I expect in terms of speech and communication abilities after laryngectomy?
  5. How long does it typically take to adapt to a new method of communication after laryngectomy?
  6. What support services are available to help with the emotional and psychological impact of laryngectomy?
  7. How often will I need to follow up with healthcare providers for maintenance and adjustments to my voice rehabilitation method?
  8. Are there any lifestyle changes or restrictions I need to be aware of after laryngectomy?
  9. How can I best prepare for the challenges and adjustments that come with life after laryngectomy?
  10. Are there any resources or support groups available for individuals who have undergone laryngectomy?

Reference

Authors: Schütz J, Rotter N, Nett S. Journal: Laryngorhinootologie. 2024 Dec;103(12):870-881. doi: 10.1055/a-2159-3984. Epub 2024 Dec 2. PMID: 39622238