Total laryngectomy is a surgical procedure consisting of removing the entire larynx and performing a reconstruction of the neck. The larynx is the physiological aero-digestive junction; its removal is a heavy intervention that causes the separation of the respiratory and the digestive tracts. It is, therefore, necessary to rebuild the neck to allow the patient to eat by mouth without risking the ingestion of food into the bronchial system (passage of food or saliva into the trachea). This reconstruction consists in restoring a continuity between the mouth and the esophagus (called neo-pharynx). The respiratory tract is also re-established by suturing the trachea at the base of the neck, through a scar called tracheostomy.
Laryngectomy is, therefore, an intervention with enormous psychological and functional consequences. Breathing, eating, smell and especially language are inevitably affected. Indeed, during a total laryngectomy, the vocal cords are removed causing a definitive disappearance of the natural voice. For more details for recovery after surgery see our article.
Communication after laryngectomy:
After the operation, the patient is often tired, depressed and weak. However, the need to communicate (even without a voice) with friends, relatives and medical staff is essential. To communicate with the carers and the entourage, several means exist: gestures, writing on a notepad, smartphone or tablets. Communication will be secondarily possible thanks to vocal rehabilitation.
The easiest way to communicate before you start exercising with your ElectroLarynx (EL) is writing. This technique is often slow and frustrating, but at the beginning of the recovery process, it is the most accurate way for the patient to communicate words to his family, friends and medical staff.
Voice rehabilitation involves teaching the patient that underwent a laryngectomy to re-speak with another voice after the operation. Several techniques can be learned with the help of orthopedists or speech therapists. In any case, the repetition of the exercises at home and the motivation make it possible to get back a voice for the patient.
The duration of learning varies according to the people and techniques used (from a few weeks to several months). If radiotherapy is indicated after the operation, this re-education often lasts longer. Whatever method is used, it is essential to know that this rehabilitation can be long and that motivation is the critical element in success.
Communication during laryngectomy recovery phase:
There are many ways to communicate before completing vocal rehabilitation:
Using a pen and a notebook:
This technique is simple, practical and above all economical. The pen and the pencil are universal expression tools that allow you to write your thoughts easily and keep them lasting. However, having to write everything to express oneself can sometimes be restrictive. Not to mention that to adopt this method of communication, a precise motor function and good vision are often required.
The smartphone is undoubtedly one of the most used means of communication nowadays. Its usefulness can also be extended to the post-laryngectomy recovery period. Indeed, almost everyone has a smartphone. In addition to the various applications dedicated to laryngectomy persons, the smartphone can simply be used as a notebook to allow the patient to communicate with friends, relatives, and medical staff. This technique dispenses with the constraint of always being equipped with a pen and paper. It saves paper and offers unlimited communication possibilities thanks to the large memory capacities of smartphones.
Some accessibility applications even allow patients to express themselves with a voice synthesized by the device. However, the disadvantage of these devices is that their use involves rather essential motor functions and dexterity. Good eyesight is also required to use this means effectively.
Tablets are also an interesting alternative to allow effective communication in the post-laryngectomy recovery period. The device’s large and bright screen can hold large letters and words and is, therefore, more easily usable, especially for patients with limited motor and visual function. Tablets also offer all the advantages of smartphones’ use.
However, it must always be kept in mind that electronic devices (smartphones and tablets) must remain charged always to be functional when needed.
Feel free to check our guide for electrolarynx use here.
To conclude, laryngectomy is a heavy and constraining intervention that changes many aspects of patients’ lives. Some solutions are available for the patients to allow the communication with their entourage and the nursing staff in the recovery phase, but they are only temporary, and patient’s motivation is the primary driver for optimal vocal rehabilitation.