Speech rehabilitation during the first year after total laryngectomy

Head Neck. 2013 Nov;35(11):1583-90. doi: 10.1002/hed.23183. Epub 2012 Nov 20.

Abstract

Background: Gaining a new voice is one of the major aims after total laryngectomy. The objective of this study was to describe the process and results of speech rehabilitation during the first year after surgery.

Methods: Speech intelligibility was measured 6 months (n = 273) and 1 year (n = 225) after total laryngectomy.

Results: Objective (23.4 to 47.5 points, p < .0001) and subjective (51.6 to 64.7 points, p < .0001) speech intelligibility improved between 6 months and 1 year after total laryngectomy. Patients who used tracheoesophageal puncture (TEP) had the best results in speech intelligibility 6 months and 1 year after total laryngectomy. In all, 12% of the patients who used TEP initially no longer used it 1 year later. Patients who had received rehabilitation had better objective speech intelligibility than those who did not.

Conclusions: Speech improves considerably between 6 months and 1 year after total laryngectomy. Nonattendance of rehabilitation is associated with a worse functional outcome in speech rehabilitation.

Keywords: head and neck neoplasms; laryngectomy; longitudinal study; prospective study; voice prosthesis.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chi-Square Distribution
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / rehabilitation*
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / methods
  • Laryngectomy / rehabilitation*
  • Larynx, Artificial
  • Male
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data
  • Prospective Studies
  • Speech Intelligibility*
  • Speech Production Measurement
  • Speech Therapy / methods
  • Speech, Esophageal / methods*
  • Statistics, Nonparametric
  • Time Factors
  • Treatment Outcome
  • Voice Quality