Laryngectomy Flashcards
What is a total laryngectomy?
Surgery to remove the larynx.
What would only remove part of the larynx?
A partial laryngectomy.
In laryngectomy what is swung up to the surface of the neck?
The trachea.
Where do laryngectomy patients breathe from?
The stoma on their neck.
in laryngectomy the functions of the _____ are also lost.
nose.
What role would the nose have normally?
- To humidify, filter and heat the air.
- Give a sense of smell.
How can laryngectomy patients moisten and warm the air they breathe in?
Using an HME. Heat and Moisture Exchangers worn in front of the stoma.
What has recently been developed?
hands free speech
What is hands free speech?
special devices and attachments have been developed that make it possible to use the voice prosthesis without having to occlude the stoma by hand.
Name the 3 voicing methods that can be learned after surgery.
- Oesophageal Speech
- Electrolarynx
- SVP (Surgical Voice Prothesis) aka. tracheoesophageal voice
___________voice is the most common speaking method and considered to be the most successful.
Tracheoesophageal.
What type of voice does tracheoesophageal create?
It creates the most natural sounding, fluent, and easiest to understand kind of voice
How is tracheoesophageal speech achieved?
a voice prosthesis is placed in a small opening between your windpipe and food tube (speech valve).
Why do people have to have a laryngectomy?
-As a result of head & neck cancer or laryngeal cancer.
Why is the cancer in the larynx quite contained?
As it is a cartilaginous structure.
Apart from layngectomy what other treatments can be used? (or combined w/ it)
Radiotherapy
Chemotherapy
how is the speech valve used to let patients to speak?
Air is pushed through with the finger, and muscles we use to burp are used to produce speech.
Name the electronic device that can be used for voicing.
Electrolarynx.
What is an electrolarynx?
a device you place on your neck and when you press a button it vibrates and generates an electronic sound that serves as your voice.
What is oesophageal speech?
press small amounts of air from your mouth into your food tube and “belch” the air up aka. burp
what is a limit to oesophageal speech?
Phrase length- can only manage 2/3 words at a time.
What are some limits to the electrolarynx?
- Pitch and Volume (sounds unnatural- but getting better w/ technology)
- Position (sometimes difficult to find a spot where it works)
- Aesthetics (quite electronic sounding, stigma of robotic voice etc.)
In terms of SVP, what is primary puncture?
The voice prothesis is placed during the same surgery to create the tracheoesophageal puncture.
Name this;
The voice prothesis is fitted several weeks after tracheoesophageal puncture.
Secondary puncture.
What is better?
-primary or secondary puncture? and why?
Primary
- early familiarity with voice prosthesis
- get used to maintenance,
- can start immediate voice rehabilitation after healing
- related social benefits
Therefore it allows faster and more successful
postoperative voicing when compared to secondary fitting.
Name 2 types of voice prothesis.
Blom
Provox.
Out of Brom and Provox, what one tends to be better?
Provox
less leakage, dislodgement, better quality of voice production, better pateient compliance in maintaining the prothesis.
Name some common problems with SVP.
- Valve failure can cause central or peripheral leak.
- Has limited lifespan of 3/4 months- has to be replaced
- Acid reflux can destroy the silicon.
- Can become infected
- can cause candidiasis (thrush)
What is the difference between a central leak and a peripheral leak?
central= leakage in the middle peripheral = leakage round the sides
What are some signs of valve failure?
- coughing when eating and drinking
- voice become gugrly
What stops food and drink leaking out when eating?
A flapper (kinda like epiglottis).
Why do larygectomy patients have to have HMEs?
Heat and Moisture Exchange systems act as the nose- moisten and warming the air in preparation to get to the lungs.
What can’t larygectomy patients do?
They can’t smell.
_______ are replaced 3-5 times a day.
HMEs
SLTs have a role in _______.
Rehab.
In the future it is hoped that…
new technology and equipment are brought out.
The handsfree kit clips into baseplate/larybutton- what does it allow?
It allows voicing without having to cover the stoma- can give patients more freedom, feeling of being normal again etc.
