VOICE PROSTHESES – TEN YEARS AFTER
Abstract
Since the introduction of tracheoesophageal puncture method by Bloom and Singer in 1980, the success of restoring vocal communication in laryngectomees has improved significantly. At the University Department of Otorhinolaringology and Cervicofacial Surgery in Ljubljana, the method has been used since 1993. We have performed 76 secondary tracheoesophageal punctures in patients with no objective contraindications and with an interest for this method. The success rate was 92%. With regard to our 10-years experience, we wanted to (re) define present and future role of tracheoesophageal voice/speech in the alaryngeal voice rehabilitation. To compare both alaryngeal speech modes, 32 patients using tracheoesophageal speech and 35 patients using esophageal speech were included into the study. In both groups the patients were established speakers. The complications that occurred in the patients with voice prostheses are presented. Most of them required only replacement of prostheses for their solution.
The tracheoesophageal puncture and voice prosthesis insertion is a reliable and fast way of restoring good voice and speech after laryngectomy. In spite of some objective disadvantage in comparison to esophageal speech – like the use of hand, need for regular maintenance, and relying to medical service, its good characteristics should rank it immediately after a good esophageal speech. This means that tracheoesophageal voice prostheses should be offered to all patients, which are not able to learn a good esophageal voice in short time, to avoid a frustrating time with no vocal communication. After tracheoesophageal puncture and voice prosthesis insertion, the patient should still get a possibility to learn esophageal speech if he wants to avoid the drawbacks of the tracheoesophageal speech.
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References
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