Voice Restoration After Total Laryngectomy

Tang, Christopher S.; Sinclair, Catherine F.

doi:10.1016/j.otc.2015.04.013

Cited by 70 publications

(66 citation statements)

References 39 publications

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“…The most likely explanation, in our view, is that both patients and health care providers focus their efforts on speech rehabilitation first, because this is the preference of the patients, as we have seen in this study, and because it is one of the most striking consequences of total laryngectomy . Moreover, speech intelligibility can be trained, making it a good target for therapeutic efforts . However, the other outcomes are also important targets of rehabilitation .…”

Section: Discussionmentioning

confidence: 77%

“…4 Moreover, speech intelligibility can be trained, making it a good target for therapeutic efforts. [40][41][42] However, the other outcomes are also important targets of rehabilitation. [43][44][45] Based on our findings, and in accordance with other studies, 16,[46][47][48] we assume that it may take considerably longer to improve quality of life and mental wellbeing after total laryngectomy, and that additional supportive treatment is necessary, including in the long term.…”

Section: Discussionmentioning

confidence: 99%

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Multicenter prospective study on the use and outcome of rehabilitation after total laryngectomy in Germany

et al. 2018

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Background The purpose of this study was to assess the use and outcome of rehabilitation after total laryngectomy in Germany. Methods We enrolled patients who were scheduled for total laryngectomy, approached them again after surgery, after 3 months and 1 year. Patients completed questionnaires and were interviewed. Results Of 309 participants, 14% had not received any rehabilitation. Reasons for nonuse were primarily ongoing treatment and poor health. Users of rehabilitation had 4 times the odds of attaining any ability to speak compared to nonusers (odds ratio 3.8, P = .02). The main aim of rehabilitation from the perspective of the users was speech rehabilitation, mentioned by 71% before starting rehabilitation. This was also what most users (27%) found the most helpful part of rehabilitation. Conclusions Patients are interested in attending rehabilitation. They especially want to improve their speech capacity, which indeed is better among users of rehabilitation than in those without.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Multicenter prospective study on the use and outcome of rehabilitation after total laryngectomy in Germany

et al. 2018

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“…Also patient satisfaction and quality of life are best in patients who received voice prostheses [144]. Some authors consider tracheoesophageal voice prosthesis as gold standard of voice rehabilitation [147]. One disadvantage of the voice prosthesis is the regular change of the prothesis and the high number of shunt insufficiencies that is characterized by transition of liquid from the esophagus into the trachea along the inserted voice prosthesis.…”

Section: Therapy Of Primarily Diagnosed Laryngeal Cancermentioning

confidence: 99%

Evidence and evidence gaps of laryngeal cancer surgery

Wiegand

2016

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 15:Doc03

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“…Reconstruction with a free revascularized jejunal autograft is performed after total pharyngolaryngectomy (TPL) in patients with advanced laryngeal carcinoma, hypopharyngeal carcinoma, or cervical esophageal carcinoma . Loss of speech after laryngectomy can significantly decrease patients' quality of life (QOL) . There are three main methods of voice restoration: usage of an electrolarynx, esophageal speech, and tracheal‐esophageal shunt speech using an indwelling voice prosthesis inserted primarily or secondarily .…”

Section: Introductionmentioning

confidence: 99%

“…The gold standard for TL patients is indwelling voice prosthesis insertion via a tracheal-esophageal puncture. 4 Although this procedure is becoming more widespread in patients who undergo TPL with free jejunal reconstruction, [6][7][8] it has been performed in only 10%-20% of such patients in Japan (clinical observations). This might be because the potential complications associated with aggressive treatments such as irradiation and extensive surgery are unknown.…”

Section: Introductionmentioning

confidence: 99%

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

Fukushima

Kanazawa

Kawabata

et al. 2017

Laryngoscope Investig Oto

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ObjectivesTotal pharyngolaryngectomy with free jejunal reconstruction is often performed in patients with hypopharyngeal carcinoma. However, postoperative speechlessness significantly decreases patient quality of life. We investigated whether Provox® insertion could preserve speech after total pharyngolaryngectomy with free jejunal reconstruction.Study DesignRetrospective chart review.MethodsA total of 130 cases of secondary Provox® insertions after total pharyngolaryngectomy with free jejunal reconstruction were analyzed. Communication outcomes were compared using the Head and Neck Cancer Understandability of Speech Subscale. Outcomes and complications associated with insertion site (jejunal insertion vs. esophageal insertion) and adjuvant irradiation therapy were also evaluated.ResultsProvox® insertion had favorable communication outcomes in 102 cases (78.4%). Neither the insertion site nor irradiation affected the communication outcome. Complications were observed in 20 cases (15.4%). Local infection was the most common complication. Free jejunal insertion, in which the resection range was enlarged, had a lower complication rate than did esophageal insertion, and its complication rate was unaffected by previous irradiation. For all patients, the hospitalization duration and duration of speechlessness were 13.4 days and 14.6 months, respectively. Patients receiving jejunal insertions had a significantly shorter hospitalization duration than did those receiving esophageal insertions. Unlike Provox®2, Provox®Vega significantly reduced the complication rate to zero.ConclusionFor jejunal inserson of a Provox® prosthetic, a sufficient margin can be maintained during total pharyngolaryngectomy and irradiation can be performed, and satisfactory communication outcomes were observed. Provox® insertion after total pharyngolaryngectomy with free jejunal reconstruction should be considered the standard therapy for voice restoration.Level of Evidence4.

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Voice Restoration After Total Laryngectomy

Cited by 70 publications

References 39 publications

Multicenter prospective study on the use and outcome of rehabilitation after total laryngectomy in Germany

Multicenter prospective study on the use and outcome of rehabilitation after total laryngectomy in Germany

Evidence and evidence gaps of laryngeal cancer surgery

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

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