Voice rehabilitation of laryngectomized patients using standard methods of voice prosthetics and our own modified methodology
General Medicine, 2023, 25(6), 31-38.
A. Asenov1,2, M. Asenova3
1 Department of Otorhinolaryngology, Faculty of Medicine, Medical university – Plovdiv
2 ENT Department, University Hospital Plovdiv – Plovdiv
3 Medical student, Faculty of Medicine, Medical University – Plovdiv
Abstract. Loss of speech function is one of the most important problems that arise in the treatment of la- ryngeal carcinoma by total laryngectomy. Implantation of a voice prosthesis in a surgically formed tracheo- esophageal fistula is currently accepted as the gold standard. The purpose of the study was to analyze the results of our own modified methodology for tracheoesophageal puncture and voice prosthesis implanta- tion, regarding the effectiveness of the method, the frequency and type of complications. A retrospective non-interventional two-center clinical study that included 51 patients who underwent tracheoesophageal fistulization for voice prosthesis implantation was performed. The study is part of a large-scale study, and the study protocol includes a detailed description of the design, inclusion and exclusion criteria, diagnostic and therapeutic procedures. The presented innovative modified technique for secondary TEP and fistula implementation based on Lichtenberger EENC is precise, safe and easier to perform compared to the original technique. Voice production in Bulgarian laryngectomized patients after TEP and voice prosthesis implantation is significantly superior to esophageal voice in terms of mean duration of phonation with one air bolus, number of words uttered with one bolus, tempo and expressiveness of speech. Voice rehabilitation through TEP and implantation of a voice prosthesis allows a significant increase in the quality of patients’ lifestyle. Based on the presented results, the effectiveness of laryngeal prosthetics after laryngectomy is an undeniable factor improving the quality of life and giving good results compared to its alternatives. At а national level, it is necessary to create an information program and reimburse the voice prostheses by the NHIF. This would allow Bulgarian patients to have alternatives and make an informed choice.
Key words: tracheoesophageal puncture, voice prosthesis, laryngectomized patients, carcinoma of the larynx
Address for correspondence: Asen Asenov, DM, PhD, e-mail: dr_assenov@yahoo.com