A Prospective Study of Tracheoesophageal Speech

Reabilitação fonatória do laringectomizado total: utilização de toxina botulínica na voz tráqueo-esofágica com prótese fonatória

“…The true need for myotomy in TEP is a controversial issue in the literature, varying from 9% to 79% in TL patients. [1][2][3][4][5][6][7][8][9][10][11][12][13] In secondary TEP, myotomy is associated with a 10% to 20% incidence of salivary fistulae, 26 with the same consequences mentioned above. Using the BT for the treatment of PES spasm makes it possible to restrict myotomy for those patients that truly require this method for treating the PES; this avoids unnecessary procedures in the remaining patients, and reduces their surgery time and complication rate.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] Altered PES motor activity in these cases is a reflex initiated by air entering the esophagus, blocking air from progressing to the pharynx. Consequently, the pharyngeal mucosa does not vibrate, and there is no phonation.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] There are three approaches for the treatment of PES alterations: myotomy of the middle and lower constrictors of the pharynx, neurectomy of the pharyngeal plexus, and the recently described chemical denervation of the PES with the botulinum toxin (BT). 6,7,8,10,11,[14][15][16][17][18][19][20][21][22][23] The BT is a presynaptic blocker of acetylcholine release at the neuromuscular junction. Videofluoroscopy 3,4,7,15,24 and computed manometry (CM) demonstrate relaxation of the PES following the use of BT in this region.…”

Reabilitação vocal pós-laringectomia total: resultados em longo prazo com prótese fonatória Blom-Singer® de longa permanência

“…The rehabilitation of total laryngectomized patients with tracheoesophageal voice with VP, after primary or secondary TEP, proved to be a more reproducible method and with fewer complications to patients 1,3,[5][6][7][8][9][10][11] . Vocal rehabilitation with esophageal voice has success rate of 24 to 26% 6,12 , but with VP this rate is increased to 58% to 94% for immediate results with primary TEP and 61% to 64% for secondary TEP 6,8,10,11,[13][14][15][16][17] .…”

“…Esophageal voice rehabilitation has a success rate of 24% to 26% 6,12 and prosthesis with TEP has an increased success rate of 58% to 94% for immediate results of primary TEP and 61% to 64% for secondary TEP 6,8,10,11,[13][14][15][16][17] . Long-term results in the literature, with one-year follow up, ranged from 65% to 85% in primary and 69% to 83% in secondary approach 6,10,[13][14][15][17][18][19][20][21][22] . The main innovation in design and shape of prosthesis placement took place in the USA and Europe, with gradual and global improvement thanks to long-term use by patients 4 .The most recent innovation was the introduction of indwelling VP to suppress the inconvenience and the problems associated with frequent exchanges of VP.…”