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Measures of Treatment Outcomes
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Helen Cocks, Raghav C. Dwivedi, Aoife M.I. Waters
Voice Prosthesis Questionnaire The Voice Prosthesis Questionnaire31 has been locally validated and looks specifically at the surgically voice-restored laryngectomee. It is a self-administered 45-point questionnaire and has sections relating to speech, leakage, valve changing, maintenance, QOL, humidification and hand-free issues.
Adult Anaesthesia
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Daphne A. Varveris, Neil G. Smart
Tracheo-oesophageal puncture allows the placement of a voice prosthesis between the trachea and the oesophagus. The voice prosthesis is a one-way valve that allows air to pass from the trachea to the pharynx when the tracheal stoma is occluded, thus preserving voice, but preventing contamination of the trachea from above.
Potential colonization of provox voice prosthesis by Candida spp. with no sign of failure for approximately 10 years exploitation time
Published in Acta Oto-Laryngologica Case Reports, 2021
Jakub Spałek, Piotr Deptuła, Bonita Durnaś, Grzegorz Król, Szczepan Kaliniak, Robert Bucki, Sławomir Okła
A 69-year-old man presented to the Otolaryngology Head and Neck Surgery Outpatient Clinic in Holly-Cross Cancer Centre (Kielce, Poland) for choking while drinking liquids. The choking was caused by transprosthetic leakage through voice prosthesis. Patient’s treatment history was shortly presented on the timeline (Figure 1). In 2001, the patient had undergone total laryngectomy, selective neck dissection on the right side (SND), and partial thyroid resection due to diagnosed squamous cell carcinoma of the larynx (stage T3N0M0). For a year, the patient used inefficient esophageal speech. In 2002, secondary surgical voice prosthesis implantation was performed and a Provox 2 8 mm voice prosthesis was inserted. The first replacement in 2004 was due to prosthesis dislocation of the esophageal flange and loss of voicing. Due to the thickening of the vocal fistula walls in the sagittal plane, the voice prosthesis was replaced with a longer one (12.5 mm). Over the next five years (2004–2009), the patient underwent eight voice prostheses replacements, the majority of which were due to transposition of the VP into the fistula canal (5), while the others were due to central leakage through the prosthesis (3). It is worth to noting that each time measurement of the fistula was performed and there were no doubts about the fitting of the VP.
Tracheoesophageal speech restoration: issues for training and clinical support
Published in Speech, Language and Hearing, 2018
Kelli Hancock, Elizabeth C. Ward, Robyn Burnett, Peta Edwards, Priscilla Lenne, Julia Maclean, Felicity Megee
The process of re-establishing communication post laryngectomy using tracheoesophageal speech (TES) is the role of the speech language pathologist (SLP) in many countries around the world (American Speech Language Hearing Association (ASHA) Position Statement, 2004; Bradley, Counter, Hurren, & Cocks, 2013; Royal College of Speech & Language Therapist (RCSLT) Clinical Guidelines, 2005; Speech Pathology Australia (SPA) Laryngectomy Clinical Guideline, 2013). The SLP role spans the continuum of care, including preoperative counselling and education, selection and fitting of the voice prosthesis, ongoing patient education and support, troubleshooting the acquisition of TES and its long term use. In recent years there have been many advances in the field of TES rehabilitation. New and enhanced voice prosthesis designs, shifting practices such as the move to inserting the voice prosthesis at the time of surgery, and the changing nature of the patient population due to extended and salvage surgery have all increased the complexity of management.
Surgical rehabilitation of the voice post total laryngectomy
Published in Hearing, Balance and Communication, 2021
C. M. Grillo, L. Maiolino, A. Borragan Torre, I. La Mantia
Our study was conducted at the University Hospital of Catania, and the data was collected at the ‘Otolaryngology Clinic’ Complex Operational Unit from 1 January 2010 to 31 December 2020. The patients considered eligible for the study were all candidates for total laryngectomy [25]. The inclusion criteria considered were: age over 18, tracheoesophageal speech utilising a voice prosthesis after laryngectomy procedures for laryngeal tumour (both primary and secondary TEP performed); oesophageal speech; clinical-instrumental follow-up after TEP performed ≥ 10 years, physical and cognitive capacity and willingness to perform a pre and post intervention clinical evaluation. Informed consent was obtained from all participants. When study participants withdrew or died, the assessments were completely cancelled. During the years of observation, 10 patients were excluded from the study, while 57 were enrolled. The enrolled patients were 49 males and 8 females, aged between 53 and 78 years (mean age: 64.7 years). Voice prosthesis following TEP (tracheoesophageal puncture) was performed as a primary choice in 13 cases while as a secondary procedure in 29 cases, on average 6 months after total laryngectomy (6.1 ± 1.4 months). The use of the oesophageal voice through adequate rehabilitation, on the other hand, was the choice for 15 patients. All enrolled patients, included in the two groups, underwent two types of subjective evaluation of the voice performance after the total laryngectomy surgery, i.e. the evaluation of the quality of life obtained through the administration of the Voice-Related Quality of Life (VR- QoL) and the evaluation of vocal performance through the Voice Handicap Index (VHI).