Laryngectomy

Question 1

What is a total laryngectomy?

Answer 1

Surgery to remove the larynx.

Question 2

What would only remove part of the larynx?

Answer 2

A partial laryngectomy.

Question 3

In laryngectomy what is swung up to the surface of the neck?

Answer 3

The trachea.

Question 4

Where do laryngectomy patients breathe from?

Answer 4

The stoma on their neck.

Question 5

in laryngectomy the functions of the _____ are also lost.

Answer 5

nose.

Question 6

What role would the nose have normally?

Answer 6

• To humidify, filter and heat the air.

- Give a sense of smell.

Question 7

How can laryngectomy patients moisten and warm the air they breathe in?

Answer 7

Using an HME. Heat and Moisture Exchangers worn in front of the stoma.

Question 8

What has recently been developed?

Answer 8

hands free speech

Question 9

What is hands free speech?

Answer 9

special devices and attachments have been developed that make it possible to use the voice prosthesis without having to occlude the stoma by hand.

Question 10

Name the 3 voicing methods that can be learned after surgery.

Answer 10

• Oesophageal Speech
• Electrolarynx
• SVP (Surgical Voice Prothesis) aka. tracheoesophageal voice

Question 11

___________voice is the most common speaking method and considered to be the most successful.

Answer 11

Tracheoesophageal.

Question 12

What type of voice does tracheoesophageal create?

Answer 12

It creates the most natural sounding, fluent, and easiest to understand kind of voice

Question 13

How is tracheoesophageal speech achieved?

Answer 13

a voice prosthesis is placed in a small opening between your windpipe and food tube (speech valve).

Question 14

Why do people have to have a laryngectomy?

Answer 14

-As a result of head & neck cancer or laryngeal cancer.

Question 15

Why is the cancer in the larynx quite contained?

Answer 15

As it is a cartilaginous structure.

Question 16

Apart from layngectomy what other treatments can be used? (or combined w/ it)

Answer 16

Radiotherapy

Chemotherapy

Question 17

how is the speech valve used to let patients to speak?

Answer 17

Air is pushed through with the finger, and muscles we use to burp are used to produce speech.

Question 18

Name the electronic device that can be used for voicing.

Answer 18

Electrolarynx.

Question 19

What is an electrolarynx?

Answer 19

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.

Question 20

What is oesophageal speech?

Answer 20

press small amounts of air from your mouth into your food tube and “belch” the air up aka. burp

Question 21

what is a limit to oesophageal speech?

Answer 21

Phrase length- can only manage 2/3 words at a time.

Question 22

What are some limits to the electrolarynx?

Answer 22

• 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.)

Question 23

In terms of SVP, what is primary puncture?

Answer 23

The voice prothesis is placed during the same surgery to create the tracheoesophageal puncture.

Question 24

Name this;

The voice prothesis is fitted several weeks after tracheoesophageal puncture.

Answer 24

Secondary puncture.

Question 25

What is better?

-primary or secondary puncture? and why?

Answer 25

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.

Question 26

Name 2 types of voice prothesis.

Answer 26

Blom

Provox.

Question 27

Out of Brom and Provox, what one tends to be better?

Answer 27

Provox

less leakage, dislodgement, better quality of voice production, better pateient compliance in maintaining the prothesis.

Question 28

Name some common problems with SVP.

Answer 28

• 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)

Question 29

What is the difference between a central leak and a peripheral leak?

Answer 29

central= leakage in the middle
peripheral = leakage round the sides

Question 30

What are some signs of valve failure?

Answer 30

• coughing when eating and drinking

- voice become gugrly

Question 31

What stops food and drink leaking out when eating?

Answer 31

A flapper (kinda like epiglottis).

Question 32

Why do larygectomy patients have to have HMEs?

Answer 32

Heat and Moisture Exchange systems act as the nose- moisten and warming the air in preparation to get to the lungs.

Question 33

What can’t larygectomy patients do?

Answer 33

They can’t smell.

Question 34

_______ are replaced 3-5 times a day.

Answer 34

HMEs

Question 35

SLTs have a role in _______.

Answer 35

Rehab.

Question 36

In the future it is hoped that…

Answer 36

new technology and equipment are brought out.

Question 37

The handsfree kit clips into baseplate/larybutton- what does it allow?

Answer 37

It allows voicing without having to cover the stoma- can give patients more freedom, feeling of being normal again etc.