Further reading, clinical insights and articles

We are often asked for educational material and articles to help in the daily management of laryngectomees. Click on the main headings to access any of the following articles.

Biomechanics of Pharyngeal Deglutitive Function Following Total Laryngectomy. Zhang, Teng & Szczesniak, Michal & Maclean, Julia & Bertrand, Paul & I Wu, Peter & Omari, Taher & J Cook, Ian. (2016). Otolaryngology -- Head and Neck Surgery. 155. . 10.1177/0194599816639249. 

Impact of a Laryngectomy and Surgical Closure Technique on Swallow Biomechanics and Dysphagia Severity
OBJECTIVE: The incidence of self-reported dysphagia following a laryngectomy is high (72%). The impact, if any, of a surgical closure technique on swallowing biomechanics and dysphagia severity is not known. To date, there is no recommended standard procedure for pharyngeal reconstruction during laryngectomy surgery. The aim of this study was to determine how laryngectomy surgery alters swallowing biomechanics, pharyngeal peak deglutitive pressure, and hypopharyngeal intrabolus pressures and whether these changes in pressure correlate with specific surgical closure after total laryngectomy or with dysphagia severity.

"Dysphagia after Total Laryngectomy" Credit to American Speech-Language- Hearing Association (ASHA)

"Methods of Voice Restoration"The inability to speak is usually the most distressing problem confronting the laryngectomy patient. Today, many choices are available to help restore speech..."  

"What is a Laryngectomy?" 

Voice Restoration With the Advantage Tracheoesophageal Voice Prosthesis

OBJECTIVES: To determine whether the Blom-Singer indwell- ing Advantage tracheoesophageal voice prosthesis (TEP) extends prosthesis life span significantly in patients with documented pre- mature device failure due to fungal colonization.

MULTIVARIABLE ANALYSIS OF RISK FACTORS FOR ENLARGEMENT OF THE TRACHEOESOPHAGEAL PUNCTURE AFTER TOTAL LARYNGECTOMY

ABSTRACT: Background. Enlarged tracheoesophageal punc- ture (TEP) is a challenging complication of surgical prosthetic voice restoration. Prevention of this complication requires identification of high-risk individuals, and surgical and prosthetic correlates of TEP enlargement.

Management of Voice Prosthesis leakage with Blom-Singer large oesophageal and tracheal flange voice prosthesis. 

INTRODUCTION: Voice rehabilitation after total laryngectomy is a major socio-economic chal- lenge. Voice rehabilitation can be achieved by voice prostheses, which provide rapid patient satisfaction. Enlarged tracheo-oesophageal puncture is a frequent complication and can be difficult to manage.

Tracheoesophageal Voice Restoration Following Laryngotracheal Separation Procedure 

INTRODUCTION: Voice rehabilitation after total laryngectomy is a major social-economic challenge. Voice rehabilitation can be achieved by voice prosthesis, which provide rapid patient satisfaction. Enlarged trace-oesophageal puncture is a frequent complication and can be difficult to manage. 

Some Comments on the Escalation of Tracheoesophageal Voice Prosthesis Dimensions

In their recent article “Downsizing of Voice Prosthesis Diameter in Patients with Laryngectomy," Eerenstein et al raise the issue of the escalating dimensions of tracheoesophageal voice prostheses and state. 

Role of Reflux in Tracheoesophageal Fistula Problems After Laryngectomy 

OBJECTIVE: The purpose of this 2 year prospective nonrandomised study wa to investigate the relationship between pathological supraesophageal reflux and the occurrence of speech fistula complications, especially severe fistula enlargement in patients who underwent total laryngectomy and prosthetic voice restoration. 

Methods of Voice Restoration

The inability to speak is usually the most distressing problem confronting the laryngectomy patient. Today, many choices are available to help restore speech.

Original Research: Voice Restoration With the Advantage Tracheoesophageal Voice Prosthesis
OBJECTIVES: To determine whether the Blom-Singer indwelling
Advantage tracheoesophageal voice prosthesis (TEP) extends
prosthesis life span significantly in patients with documented premature device failure due to fungal colonization.

 

"A laryngectomy is the surgical removal of the larynx. The larynx, also called the voice box, is the organ in the throat that creates speech and, in conjunction with the epiglottis, prevents food from entering the airway during swallowing..."

Troubleshooting Guide
"The following recommendations are provided by Dr Eric D. Blom, Ph. D..."

 

CLINICAL INSIGHTS 
CI 2000 – Neck Breather Medical Awareness Skin Decal
"For many years laryngectomees have experienced legitimate fears regarding care and protection of their tracheostoma when temporarily hospitalized or in other settings where medical personnel may be unfamiliar with a “total neck breather. The Neck Breather Medical Awareness Skin Decal (patent pending) is a unique warning system...”

 

CI 1998 – Tracheostoma Valve Attachment
"Patients vary in their interest and degree of successful use of a
tracheostoma valve..."

 

CI 1997 – Leakage Around a Tracheoesophageal Voice Prosthesis

"Leakage of liquids around a voice prosthesis will not occur if the
tracheoesophageal tissue is healthy and if the puncture is fit with an appropriate length prosthesis. Two factors contribute to the prevention of leakage..."

 

CI 1996 – Types of Voice Prosthesis and when to use them
"There are two basic Blom-Singer® voice prostheses; duckbill and low pressure..."

 

CI 1995 – A Small Colony of Yeast Can Make A Prosthesis Leak
"Yeast infections in the mouth are common in head and neck cancer patients, particularly among those who have been
treated with radiation or chemotherapy..."

 

CI 1994 – Tracheoesophageal Puncture Measurement Errors
"Tracheoesophageal puncture measurement is critical to selecting
and fitting the correct length voice prosthesis..."