The Stout prosthesis: An alternate means of restoring speech in selected laryngectomy patients

Abstract

We discuss the effectiveness of the Stout prosthesis, a device that was developed more than 30 years ago to restore speech in postlaryngectomy patients. This prosthesis has not been previously described in the literature. The placement of this device entails the creation of a pharyngeal cutaneous fistula that extends to the musculature at the base of the tongue. The prosthesis is then used to connect the fistula and the stoma. Central to this discussion was our evaluation of a patient who had used the Stout prosthesis for 30 years. In this patient, the prosthesis produced excellent long-term voice production with minimal leakage of saliva or other liquids. We conclude that in light of the device's simplicity, low cost, and minimal maintenance requirements with regard to the fistula site, the Stout prosthesis should be considered as an alternative to the standard tracheoesophageal puncture method for patients who are unable to comply with the latter's maintenance requirements and for those in poorly developed countries where costs and hygiene are paramount considerations. Moreover, because the Stout technique does not involve the esophagus and does not require invasive procedures around the stoma, it is also practical for patients who have esophageal rigidity or stomal problems.