Voice restoration following total laryngectomy by tracheoesophageal prosthesis : initial experience at king hussein medical center

Abstract EN

Objective: This study presents preliminary results of using a tracheoesophageal prosthesis for voice restoration following total laryngectomy at King Hussein Medical Center.

Our measures include patients' satisfaction, and perceptual ratings by family members, clinicians as well as the mean life time of the prosthesis.

Methods: Patients included twelve laryngectomees two months to 15 years following total laryngectomy.

A tracheoesophageal puncture was placed in each patient, followed by fitting with voice prosthesis.

Tracheoesophageal prosthesis speakers were asked to rate their satisfaction with their new speech on a 10-point rating scale, while a close family member was asked to judge the three parameters of patients' everyday speech as good, fair, or poor.

Audiorecordings of tracheoesophageal prosthesis speech were rated by a panel of 24 students in a speech pathology undergraduate training program according to general intelligibility and six other parameters of voice on a 7-point rating scale.

Results: Our entire cohort was able to phonate and speak immediately after the insertion of the tracheoesophageal prosthesis with minimal training.

All patients reported high satisfaction with their new speech and were quite cooperative during regular visits and follow ups for trouble shooting.

The only factor that affected the patients' satisfaction was the need to use one hand to close the stoma.

The primary complication was leakage through the prosthesis due to fungal infections.

Most family members rated the quality, loudness, and intelligibility of tracheoesophageal prosthesis speech as fair to good.

Listeners' ratings of quality, pitch, and prosody of tracheoesophageal prosthesis speech were relatively low, while their ratings of rate, articulation accuracy, and general intelligibility were higher.

Conclusion: Although the quality of tracheoesophageal speech was not good, speech rate, articulation, and general intelligibility were near normal.

Tracheo-esophageal speech was highly accepted by Jordanian laryngectomees and their families.

This is very significant, because other forms of voice restoration have not been acceptable to most Jordanian patients.