The Role of Esophagus in Voice Rehabilitation of Laryngectomees

Abstract

The total laryngectomy is a standard procedure of laryngeal carcinoma treatment which leaves multiple persistent consequences on a laryngectomized person. After laryngectomy, all of patients cannot speak loudly, and 10-58% patients have a dysphagia. In such changed anatomical condition, the esophagus has a key function in two of three primary approaches to voice-speech rehabilitation of laryngectomized patients: esophageal and tracheoesophageal speech therapy method because one of these is the only acceptable solution of substitute alaryngeal speech. In esophageal speech, the esophagus has the role of speech air reservoirs since the respiratory and digestive pathways are permanently separated after the procedure. In the production of tracheoesophageal speech, the tracheoesophageal fistula and the esophagus allow the recommunication of these pathways and the use of air from the lungs for speech. There are several prerequisites for successful esophageal and tracheoesophageal speech. After tracheoesophageal puncture and insertion, the tracheoesophageal prosthesis may occur different complications in the early or late postoperative period in 10-60% of patients. The quality of alaryngeal voice is very different from the quality of laryngeal voice, but allows communication to laryngectomees.

Let bubble solve the trouble

“…Nasogastric (NG) tube is of immense importance post-laryngectomy to maintain nutrition and to serve as a scaffold for the formation of neopharynx. [ 1 ] Despite being inserted pre-laryngectomy, rare inadvertent dislodgements have been reported,[ 2 ] which is undoubtedly risky as it can lead to disruption of surgical closure, formation of pharyngocutaneous fistula, and subsequent wound complications. [ 3 ] Because of the altered oropharyngeal anatomy and the presence of an inflated cuffed tracheostomy tube, post-laryngectomy reinsertion of NG tube is challenging with the level of risk increasing with repeated attempts.…”