Solutions after a total laryngectomy
Positive and negative points of different solutions
The patients that have undergone a total laryngectomy surgery and lost their vocal cords are unable to speak with their own voices. After the surgery, patients have begun to inhale through a specially made opening called a “stoma”. This is a very serious surgery intervention and creates immense stress in the patients’ lives. Regardless of this, it is possible to change your communication style and resume normal communication when speaking with other people or on the phone.
Actually, you can get your voice back.
There are three different solutions to help the laryngectomee communicate after total laryngectomy and speak again. Every method requires patience and practice to re-learn speaking again though with some differences.
In this article, we will focus on these differences from the point of view of comfort over time.
What could be a solution to speak again after a laryngectomy intervention?
Here are listed the most common solutions:
- Voice prosthesis or tracheoesophageal puncture (TEP)
- Esophageal speech or swallowing air
- Electrolarynx device
Voice prosthesis or tracheoesophageal puncture (TEP)
Nowadays this is the most commonly used method. TEP surgery is conducted primarily as part of the laryngectomy intervention. In addition to the stoma, the surgeon makes a tiny hole called a fistula at the back of your stoma. The hole creates an opening between your windpipe and food pipe (esophagus).
Then the surgeon puts a one-way prosthesis that lets the air from the lungs enter the oral cavity.
Some voice prosthesis valves are external. This means they are meant to be taken out for cleaning. Other types of valves are internal. These valves should remain in place until they have to be exchanged. The change has to be done approximately every 6 months unless they start leaking earlier.
Positives of TEP:
- The patient has both hands free while doing something.
- There is an option to change the tone by changing the pressure on the stoma thus having a more natural speech.
- This is the fastest way to start speaking after the laryngectomy.
Negatives for TEP:
- It is not suitable for everyone. You have to meet some health requirements to be able to use it. Some people might have muscle spasms in their pharynx and so they face difficulties speaking with TEP.
- The overall price shows that this method is expensive. It varies from country to country.
- There is compulsory maintenance required, for example cleaning after having some food.
- TEPs require frequent adjustment as the human body is constantly changing the stoma.
- Depending on the type and producer, the TEP lasts from 3 months to one year and has to be replaced by specialized staff.
As a result, in most cases, patients have to visit the hospital twice or more per year and may feel dependent on this help.
Esophageal speech or talking through the stomach.
By doing special exercises, patients can achieve an intake of a certain volume of air into the stomach and subsequently use it for speaking, as the outgoing air stream can be transformed by articulations into speech.
This method is very popular in some countries in the Far East and Russia.
The advantage of the esophageal speech is only one:
- Independence. You don’t need any external additives or devices. Both hands are always free.
However, the negatives are much more significant:
- Learning this method is not easy, it might take months and not be achievable for everyone.
- Using it requires serious physical strength and is tiring.
- There is evidence that over time, especially after a year following laryngectomy, the condition and functioning of the digestive system deteriorates. This has serious consequences for human health.
Electrolarynx speech aid
The electrolarynx is a battery-powered device that generates vibrations. By pressing the electrolarynx against the neck these vibrations can enter the oral cavity and together with the articulation they make it possible to speak. This method to get your voice back after a total laryngectomy is a common solution for many years.
Positives while using electrolarynges:
- Very simple to use and easy to learn how to use it.
- Very simple maintenance - recharge or exchange the battery. Modern electrolarynges also offer a speaking time of tens of hours by a single charge.
- There is no need for medical specialists to support the device
- There is no need to visit hospitals regularly
- In most countries, there are reimbursement programs for electrolarynges. This makes them free of charge for the patients or very cheap to obtain.
Negatives while using electrolarynges:
- With most electrolarynx models on the market, the voice is flat and sounds mechanical. However, there are electrolarynges that let the patient change the tone during speech. For example, Trutone Emote and Labex Inspiration.
- While speaking one of your hands is busy.
- You have to monitor the remaining capacity of the battery. Modern digital devices will alarm you when the battery is about to be down.
In a conclusion
We want to note that the well-known electrolarynges are a bit neglected for reasons outside the real benefits which they can offer.
These simple and affordable devices can grand more independence after laryngectomy for many years. They can really and in a very simple manner restore the communication ability to a satisfactory level.
Electrolarynges are very handy and useful for people with a parietal loss of their voice, too. These devices can help people that can’t be heard for different reasons, insufficient power in the lungs or some difficulties with voice power, pain in the neck, or panting.
Last but not least, they are a good backup in any case. Modern digital electrolarynges offer remarkable speech time and speech options which definitely deserve your attention.