Professional paper

Voice restoration using tracheoesophageal voice prostheses following total laryngectomy

Robert Tićac ; Clinics for otorinolaringology, Clinical hospital centre Rijeka, Rijeka, Croatia
Brigita Tićac ; Department of microbiology and parasitology, School of medicine, University of Rijeka, Rijeka, Croatia
Boris Maljevac ; Clinics for otorinolaringology, Clinical hospital centre Rijeka, Rijeka, Croatia
Marko Velepić ; Clinics for otorinolaringology, Clinical hospital centre Rijeka, Rijeka, Croatia
Goran Malvić ; Clinics for otorinolaringology, Clinical hospital centre Rijeka, Rijeka, Croatia
Darinka Vučković ; Department of microbiology and parasitology, School of medicine, University of Rijeka, Rijeka, Croatia
Darko Manestar ; Clinics for otorinolaringology, Clinical hospital centre Rijeka, Rijeka, Croatia

Abstract

Aim: Total laryngectomy is an expansive operation and can be performed with or without neck dissection. During this procedure the entire larynx is removed, the windpipe is brought out to the skin and secured there in the form of a permanent tracheostome. The most difficult aspect of laryngeal function to reconstruct, and the one to which most research is dedicated to is the reattainment of speech. The main options for voice restoration after total laryngectomy are esophageal speech, electrolarynx speech, and tracheoesophageal speech. Tracheoesophageal puncture with prosthesis is currently the surgical method of choice for vocal restoration after total laryngectomy. This puncture tract can be created primarily, at the time of total laryngectomy, or secondarily, weeks or years following the laryngectomy.
Patients and Methods: Between the period of 01.01.2004. and
31.12.2008., 125 laryngectomized patients have been rehabilitated at the Otorhynolaryngology Department of the Clinical Hospital Center Rijeka. The indication for total laryngectomy was T3 or T4 laryngeal carcinoma in 58 (46%) patients, and 67 (54%) patients underwent a partial laryngectomy.
Results: The methods of voice rehabilitation were tracheoesophageal speech (91%), esophageal speech (6%) and artificial larynx (3%). A voice prosthesis could be inserted in 49 patients by primary puncture, in 36 patients by secondary puncture. The median device lifetime was 7,9 months. 10 % of the prostheses were replaced with a lifetime of less than 3 months, 46% from 3 to 6 months, and
44% devices longer than 6 months.
Conclusion: Effective restoration of voice is critical to enabling
the patient to return to normal functioning in their life. Tracheoesophageal speech has become the method of choice for postlaryngectomy voice restoration.

Keywords

total laringectomy; tracheoesophageal puncture; vocal prostheses

Hrčak ID:

38813

URI

https://hrcak.srce.hr/38813

Publication date:

1.6.2009.

Article data in other languages: croatian

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