The Voice Restoration After Total Laryngectomy in Advanced Laryngeal and Hypopharyngeal Cancer

Juei-Fu Hung ； Cheng-Ming Hsu

《International Journal of Head and Neck Science》 6卷3期 (2022/09) Pp. 95-99

https://doi.org/10.6696/IJHNS.202209_6(3).0001

摘要

Background: Laryngeal and hypopharyngeal cancers are the common malignancies among all types of head and neck cancers. Total laryngectomy (TL) is the removal of the entire larynx. Changes in the anatomy and physiology of airways after TL cause not only loss of laryngeal speech but also social participation. Methods: A literature review. Results: For esophageal speakers, a great number of practices are inevitable. This fact also gives rise to the low success rate of esophageal speech comparing to other rehabilitation methods. Esophageal speech is no doubt the hardest voice rehabilitation option to learn. Despite such difficulty, it is still widely used in third world countries because of the relatively low cost. Artificial larynx including pneumatic or electrolarynx is the simplest way of vocal rehabilitation option for patients undergoing TL. Little training or patient selection was required. Tracheoesophageal speech is the gold standard of voice restoring and the voice rehabilitation of choice in developed countries or for patients with fair financial status. Conclusions: No matter which method the patient uses to restore the voice, the most important thing is to return to society as soon as possible to avoid psychological and social problems. The public can better understand and accept people without throats, so the patient post TL can ＂speak＂ bravely in public, whether using artificial larynx or tracheoesophageal speech. Head and neck surgeons still should try their best to preserve the patient's larynx while maintaining the patient's survival, including the use of transoral robotic surgery.

關鍵字

total laryngectomy ； laryngeal and hypopharyngeal cancers ； artificial larynx ； tracheoesophageal speech ； transoral robotic surgery