VOICE REHABILITATION AFTER TOTAL LARYNGECTOMY
- VernacularTitle:VOICE REHABILITATION AFTER TOTAL LARYNGECTOMY
- Author:
L.Byambasuren
;
E.Bayarmaa
;
Sh.Bat-Erdene
;
A.Bayarsaikhan
;
B.Goosh
;
L.Galtsog
;
D.Sambuupurev
- Publication Type:journal article
- Keywords:
Laryngeal cancer, total laryngectomy, tracheoesophageal puncture, voice prosthesis.
- From:Innovation
2007;4(1):52-55
- CountryMongolia
- Language:English
-
Abstract:
BACKGROUND
The laryngeal cancer (LC) composing 40-60 % of all head and neck cancer is the most common one. In our country, after the introduction of total laryngectomy in 1972 at the Central State Clinical Hospital the voice rehabilitation was not undertaken till present. Therefore, we aimed our study goal in performing the improved voice rehabilitation therapy after total laryngectomy in Mongolia for prolonging the patient life expectation, improving the patient quality of life.
METHODS
This study was performed at the ENT- Department of the State Central Clinical Hospital, the Bacteriological Laboratory, the Phoniatry Cabinet, the laboratory of State Center of Pathology in period between 2004-2006.
Primary tracheoesophageal puncture surgery or implantation during the total laryngectomy was performed in 7 patients, secondary tracheoesophageal puncture surgery or implantation after the total laryngectomy was undertaken in 6 patients.
We used in our study kinds of prothesis: Blom-Singcr prosthesis, A- indwelling low pressure B-low pressure . We developed voice exercise methodology based on Mongolian phonetic and involved the patients in voice rehabilitation session after the prosthesis insertion.
RESULTS
Among the patients received the voice rehabilitation prosthesis, in 11 (84.6%) the voice and speech function were recovered, and three patients (23,1%) could not speak completely. From them, 6 of 7 patients received the primary puncture (85.7%), and 4 (66,6%) of 6 received the secondary puncture .
Voice frequency evalation after total laryngectomy by videolaryngostroboscopy compared with the frequency of healthy persons was dccrescd in 5-11 times, after the prosthesis implantation it neared almost to the indicators of the healthy. But the voice strength, maximal phonation time, word number etc. indicators were 14-17.2% less than those in the control group.
From 13 patients involved in our study, 6 received the indwelling low pressure prosthesis ( A group). 7- low-pressure prosthesis ( B group); in 5 (83,3%) from A group and 5 from B group (71,4%) the voice was recovered. By studying the prosthesis usage duration, from 5 patients of A group 2 used the prosthesis for I year, 2- for 1.5 year and I patients used prosthesis for doubled duration. 5 patients of B group used their prosthesis for the perio(| 1-2.5 times longer than prescribed. The main cause for prothesis exchange is fungal growth /infection/ on the prosthesis valve and its external parts, which impaired (he sound production.
CONCLUSION
Voice prosthesis was in 84 5% cases of our study effective; primary puncture doesn't require repeated surg^y, its voiee rehabilitation is rapid and more effective. (P<0.01).
