Post laryngectomy speech rehabilitation outcome in elderly patients

Abstract

The aim of our work has been to evaluate the different options of tracheoesophageal voice rehabilitation in over 70-year-old patients, who had undergone laryngectomy, assessing advantages and drawbacks of this method of vocal recovery. A retrospective study has been carried out. This has included 40 subjects, all aged more than 70 years old, who have been referred to tracheoesophageal voice rehabilitation. It has been realized a phonatory fistula between trachea and esophagus with prosthesis positioning by means of a primary puncture in 18 cases and it has been realized a secondary puncture in 22 cases. The results gathered in these patients were compared with data obtained from a group made of 39 patients, less than 70 years of age that therefore represented our control group. In primary tracheoesophageal puncture (TEP), the short-term success was 67 %, while in the 22 cases who underwent secondary TEP, the short-term success was 64 %. After 2 years from TEP, the long-term success was 82.5 %. In the control group, the short-term success was 65 % in primary TEP and 73 % in secondary TEP. After 2 years from TEP, the long-term success was 77 %. The evaluation of the results has shown the absence of a statistically significant difference both as regards complications incidence, during and after surgery (p [ 0.9) and as regards overall success ratio of prosthesis implants between the two groups (p [ 0.7). The possibilities of tracheoesophageal recovery of elderly patients do not show dissimilarities in comparison with the results in younger subjects.

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

“…The duration of speechlessness in our study was 14.2 months, which is similar to that reported in a previous study . It was longer in patients who underwent postoperative irradiation than in those who underwent preoperative irradiation.…”

“…The duration of speechlessness in our study was 14.2 months, which is similar to that reported in a previous study. 24 It was longer in patients who underwent postoperative irradiation than in those who underwent preoperative irradiation. This would be expected since the need for postoperative therapy would delay the time to subsequent insertion and therefore extend the duration of speechlessness.…”

Riabilitazione vocale post laringectomia con voce protesica: 15 anni di esperienza della Clinica Otorinolaringoiatrica dell’Università di Catania. Analisi retrospettiva dei dati e revisione della letteratura

“…The results from these patients were compared with data obtained from a group of 39 patients, less than 70 years of age, which thus represented the control group. The results showed the absence of a statistically significant difference in incidence of complications, during and after surgery (p>0.9) as well as the overall success ratio of prosthesis implants between the two groups (p>0.7) 12 . In this context, the ability of the larynx of the elderly to functional recovery after partial laryngectomy is widely known 13 .…”

Management of Advanced Laryngeal Cancer

“…The best method for speech rehabilitation would appear to be surgical voice restoration with tracheo-esophageal speech after tracheo-esophageal prosthesis placement 49. A high success rate for surgical voice restoration is reported by many authors;50–52 however, other studies which have endeavored to capture and follow up all patients undergoing total laryngectomy report the use of successful tracheo-esophageal speech in around half of patients 49. Of those who do not achieve successful tracheo-esophageal speech, some will achieve reasonable esophageal speech.…”