Elsevier

American Journal of Otolaryngology

Volume 3, Issue 1, January–February 1982, Pages 1-7
American Journal of Otolaryngology

Current status of laryngectomee rehabilitation: I. Results of therapy**

https://doi.org/10.1016/S0196-0709(82)80025-2Get rights and content

Of 103 people with the clinical diagnosis of laryngeal cancer studied by the authors, 53 eventually were treated by total laryngectomy and, in some cases, radical neck dissection (43), preoperative radiation therapy (15), postoperative radiation therapy (29), and postgram. Six months following completion of their cancer therapy 47 were re-evaluated. Of these, 12 (26 per cent) used esophageal speech as the dominant mode of communication, 16 (34 per cent) the electrolarynx, and the remainder either wrote (16 [34 per cent]) or signed (3 [6 per cent]). Twenty-six (55 per cent) were considered to be successfully rehabilitated overall and 21 (45 per cent) were not. These data indicate that the rehabilitative needs of today's laryngectomee are not being met successfully with traditional methods.

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    Although long-term rates of spoken communication acquisition are typically high, many individuals experience significant communication difficulties after TL. Prospective studies have demonstrated that at least 40% of individuals continue to experience significant, socially limiting communication difficulties for six months or more after TL and often use writing as their primary method of communication (Armstrong et al., 2001; Gates et al., 1982; List et al., 1996). Those who do not develop alaryngeal speech have the poorest outcomes with regard to communication, satisfaction, and quality of life (Clements, Rassekh, Seikaly, Hokanson, & Calhoun, 1997; Hillman, Walsh, Wolf, Fisher, & Hong, 1998; Palmer & Graham, 2004).

  • A questionnaire to assess olfactory rehabilitation for laryngectomized patients (Provox voice prosthesis users) in Japan

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    However, long-term training is required to acquire esophageal speech. Despite such training, the acquisition rate is low at 33% [17], and even if patients acquire esophageal speech, the vocal loudness is insufficient. Low vocal volume occurs because the esophageal volume ranges 40–80 cc [18], which is roughly 2% of the volume of the lungs (2200–4690 cc each) [19].

  • The multidimensional impact of total laryngectomy on women

    2015, Journal of Communication Disorders
  • Effects of Laryngeal Cancer on Voice and Swallowing

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    Esophageal speech, although once the mainstay of alaryngeal voice restoration, has less clinical popularity today because of lower levels of successful acquisition and poorer intelligibility ratings in contrast to tracheoesophageal speech [59,60]. In fact it is estimated that up to 75% of those attempting esophageal speech are unable to successfully acquire this modality [61]. The advent of the tracheoesophageal voice prosthesis (TEP) has revolutionized postoperative alaryngeal voice restoration [62].

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**

Supported by a grant (R18 CA18629-02) from the National Institutes of Health.

*

Professor and Head, Division of Otorhinolaryngology, The University of Texas Health Science Center, San Antonio, Texas.

Chief of Audiology and Speech Pathology, Veterans Administration Medical Center, Albuquerque, New Mexico.

Associate Professor and Chief of Audiology, Division of Otorhinolaryngology, The University of Texas Health Science Center, San Antonio, Texas.

§

Professor, Department of Psychology, North Texas State University, Denton, Texas.

Research Associate, Division of Otorhinolaryngology, The University of Texas Health Science Center at San Antonio, Texas.

Clinical Assistant Professor, Department of Physical Medicine, and Rehabilitation, The University of Texas Health Science Center at San Antonio, Texas.

**

Associate Professor, Division of Gastroenterology, The University of Texas Health Science Center at San Antonio, Texas.

††

Assistant Professor (Biostatistics), Division of Otorhinolaryngology, The University of Texas Health Science Center, San Antonio, Texas.

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