Laryngeal cancer accounts for about 1% of all cancers. About 12,000 new cases are diagnosed each year in the US and men are typically affected about five times more often than women. Cancer of the larynx may lead to the need for radical surgery in order to save the person’s life. This life-preserving surgery is called a laryngectomy.
Undergoing a laryngectomy (surgery to remove all of the larynx or parts of the larynx) significantly changes a person’s life, anatomically and psychologically. The head and neck surgeon will remove the larynx and reconstruct the area. Because the larynx is removed, the vocal folds are removed as well, making a new method of communication necessary.
All of our speech pathologists are specialty trained in voice restoration following the laryngectomy, and they are committed to providing the best communication method and best voice for each patient.
Prior to surgery, a counseling session with one of our speech-language pathologists is highly recommended in order to thoroughly discuss the physical, emotional, and functional changes that will occur. During this session, patients will have the opportunity to ask any and all questions they may have. Family members and friends are encouraged to attend and we will make every effort to have one of our post-laryngectomy patients available in order to provide support and share their experience.
There are 3 main communication options to choose from post-surgery:
Our speech-language pathologists are trained to maximize the ease and effectiveness of communication using any of these methods.
Alaryngeal device: An electronic alaryngeal device called an electrolarynx may be used following surgery in order to communicate. This device acts as a separate sound source that a patient may use as soon as 48 hours after the laryngectomy to begin to speak with family and friends in the hospital during his or her recovery time there. Some patients may prefer to continue electrolarynx use as their main way of communicating, and we offer training on this method with a focus on maximizing intelligibility.
Esophageal speech: If this method of communication is chosen, the patient will need to come for intense speech therapy following recovery from the laryngectomy in order to learn how to swallow air into the esophagus (food tube) which can be used to speak. As the air in the esophagus is expelled, tissue at the back of the throat will vibrate to form a voice source. The vibrating portion of tissue in the back of the throat is called the pharyngoesophageal (PE) segment. The teeth, tongue, and lips are used to speak as they had been preoperatively, however the sound will be of a lower pitch. Esophageal speech does not require any additional surgical procedures or devices, but extensive voice therapy is necessary to learn this speaking method. There may also be limitations on whether this is the best speaking option, as it depends on the patient’s post-operative healing and outcome. This is an issue best discussed with your speech pathologist.
TEP speech: The creation of a tract to house a speaking valve called a tracheoesophageal voice prosthesis (TEP) may occur during the initial laryngectomy or at a later date. Having TEP surgery enables patients to communicate using a small prosthesis that connects the trachea with the esophagus. About 90% of our laryngectomy patients use this method of communication. Our center is well equipped with these devices and many other appliances meant to assist with pulmonary rehabilitation and ease of voice production that enhance the speech and lives of our patients.