A brief review of voice restoration following total laryngectomy

Abstract

Despite advances in conservative laryngeal surgery and radiotherapy, total laryngectomy still remains the procedure of choice for advanced-stage (UICC T3 and T4) laryngeal carcinoma, around the world. The functional rehabilitation of the laryngectomized patients has been a concern of head and neck surgeons and speech therapists. Significant developments in speech rehabilitation over the past three decades have led to substantial improvements in the quality of life of these patients. The tracheoesophageal (TE) voice prosthesis has become the gold standard in various centers for voice rehabilitation since its introduction in 1980. Successful tracheoesophageal voice restoration in laryngectomy patients can be very rewarding and patients no longer have to live in silence while they await the results of their cancer treatments. They can face the challenges of life with the knowledge that a near normal quality of life is very much possible.In this article, we present a brief review of voice restoration following laryngectomy.

The impact of vocal rehabilitation on quality of life and voice handicap in patients with total laryngectomy

“…[3] Quality of life (QOL) is strongly impaired in patients suffering from voice loss, smell loss, respiratory tract changes, changes in lung function, weak cough reflexes, and complications associated with permanent tracheostomy. [4] Voice disorders and subsequent communication problems are perhaps the most obvious problems, and the rehabilitation process focuses on reestablishing functional communication. [3] There are several voice rehabilitation options available following total laryngectomy, including esophageal speech (ES) with air injected into and then expelled from the esophagus in a controlled way, tracheoesophageal voice prosthesis (TEP) using air inhaled during breathing or using the reconstructed pharynx as the new sound source (pharyngoesophageal [PE] segment), and electrolaryngeal speech.…”

A Multidisciplinary Team Guided Approach to the Management of cT3 Laryngeal Cancer: A Retrospective Analysis of 104 Cases

“…In patients deemed to be suboptimal candidates for organ preservation strategies due to tumor- or comorbidity-related considerations, upfront TL should still be considered as an affordable and extremely reproducible procedure. While definitely unsurpassed in terms of oncological radicality, TL may also be compatible with a reasonable quality of life that, even though inherently subjective, is strongly ameliorated by the systematic application of tracheo-esophageal puncture [55,56].…”

Prosthetic rehabilitation of a total laryngectomy patient

“…Among these the vocal rehabilitation by voice prosthesis, after total laryngectomy has represented the gold standard for the last two decades. [ 3 4 ]…”