The Report of Voice Rehabilitation after Total Laryngectomy

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J Korean Soc Laryngol Phoniatr Logop > Volume 13(2); 2002 > Article

Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2002;13(2): 155-163.

후두전적출환자의 Voice Rehabilitation에 대한보고

최홍식, 최성희, 김한수, 홍진희, 남지인, 김세헌, 김광문

연세대학교 의과대학 이비인후과학교실, 음성언어의학연구소

The Report of Voice Rehabilitation after Total Laryngectomy

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ABSTRACT

Background and Objectives
: Esophageal voice, Silicone voice Prosthesis with tracheo-esophageal (T-E) puncture have been used as vocal rehabilitation methods for postlaryngectomy. However, long-term follow-up in the voice rehabilitation in the total laryngectomees has not been reported. The purpose of this study is to analyze practice of postlaryngectomy voice rehabilitation and to find the effective voice rehabilitation.
Materials and Method
s : From Jan 1992 until June 2002, 75 patients underwent a total laryngectomy at Yongdong Severance Hospital. We retrospectively studied voice rehabilitation methods commonly used, acquisition levels of esophageal speech, patients satisfaction scale (5 rating scale) according to the methods in 33 of them (40 died, 2 unavailable) by using charts review, telephone interview.
Results
: T-E speech is most commonly used by 14 patients (42.4%) : A tracheo-esophageal procedure (primary or secondary puncture) by 21 : and 8 patients removed Provox. 1 patient had no voice rehabilitation. 7 patients (21.2%) have used esophageal speech : 4 patients of them have used it after removing Provox. Electrolarynx has been used with other voice rehabilitation methods : 4 patients have only used this method and 3 patients with T-E speech, 1 patient with esophageal speech. However, 6 patients (18%) remained without a substitute voice rehabilitation. In the satisfaction with speech and management of voice rehabilitation methods, patients using esophageal speech were most satisfied (4.1), patients with T-E speech were unsatisfied (2.3). Regarding with the acquisition level of esophageal speech in 33 patients, 22 patients (66.6%) failed without functional speech.
Conclusion
: To increase patients satisfaction and to achieve successful voice rehabilitation after total laryngectomy, preoperative counseling, pretesting, appropriate patient selection of each method and team decision-making and postoperative voice therapy must be considered.

KEY WORDS： Total laryngectomy;Voice rehabilitation;

중심 단어： 후두전적출술;음성재활;