Voice Rehabilitation After Laryngectomy: A Regional Cancer Centre Experience and Review of Literature
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Voice Rehabilitation After Laryngectomy: A Regional Cancer Centre Experience and Review of Literature Elizabeth Mathew Iype1 • Deepak Janardhanan1 • Shirish Patil1 Sandeep Suresh1 • Bipin T. Varghese1 • Shaji Thomas1
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Received: 2 March 2019 / Accepted: 11 July 2019 Ó Association of Otolaryngologists of India 2019
Abstract Alaryngeal speech in laryngectomees has revolutionized the patient outlook toward the morbid procedure and the concept of permanent stoma unlike olden era when stigma of stoma with loss of voice was rampant. To analyse acceptance of voice rehabilitation options and their success and management of complications in a tertiary care centre. All patients who underwent laryngectomy from August 2014 to 2018 June at our institution were included in the study. The voice rehabilitation options like oesophageal speech, tracheao-oesophageal puncture and voice prosthesis insertion (TEP), and electrolarynx were explained to the patients. The options put forward to the patients, the importance of Taub test, Interval between treatment and secondary TEP insertion, life span of the prosthesis, Patients acceptance and success rates and the troubleshooting were noted. A total of 96 patients underwent total laryngectomy, 72 patients were willing for rehabilitation. 15% (11) patients had primary TEP, 22% (16) had secondary TEP insertion, esophageal speech in 36% (26) patients and 27% (19) patients opted for the electrolarynx. The rest 24 patients were not keen on any further interventions after laryngectomy. Speech rehabilitation is an integral part in surgical management of carcinoma of the larynx. Alaryngeal speech in laryngectomees have
This article was presented as a Poster in IASO NATCON 2019 (Surgical oncology) held in Trivandrum, Kerala India in September 20–23rd 2018. & Shirish Patil [email protected] 1
Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala 695011, India
revolutionized the patient outlook towards the morbid procedure. Esophageal speech is the least successful method of rehabilitation but still the cheapest method and requires a lot of motivation. Primary and Secondary TEP insertions have similar success rates. Successful treatment for cancer of larynx ends with successful voice rehabilitation. Keywords Voice rehabilitation TEP Laryngeal cancer
Introduction In 1859, Czermak et al. [1, 2] described a girl with laryngeal stenosis who was able to vocalize by deflecting airflow from a tracheostomy to the tongue base., The first case of producing an intelligible speech after total laryngectomy (TL) was described by Gussenbauer [3] in 1874 at the third Congress of the German Company of Surgeons in Berlin when he fitted Billroth’s first TL patient with a reedlike device mounted onto a double-lumen tracheostomy tube with a port extending into the pharynx. Since then the evolution of voice rehabilitation has undergone lot of improvement due to innovative thinking, research and development. Esophageal speech was introduced in the mid-ninet
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