A surgical incision between the trachea and esophagus (tracheo-esophageal puncture) following removal of the tongue and voice box provides effective speech communication for select head and neck cancer patients who otherwise would not be able to speak.
Most treatments for tongue and voice box cancer allow patients to retain those organs and maintain speech communication. For those few patients whose cancers do not respond to organ-sparing techniques, surgical removal of the tongue (glossectomy) and voice box (laryngectomy) may be necessary. When the tongue and voice box are both removed, understandable speech communication becomes impossible, leading to a decline in the quality of life for the patient.
Now, researchers have developed an option that can restore understandable speech to this select patient group. After the total laryngectomy and glossectomy, a tracheoesophageal puncture (TEP), an incision between the trachea and esophagus that is fitted with a small plastic or silicone valve, is performed. With the help of post operative speech rehabilitation therapy, this procedure can provide understandable speech communication and improve quality of life. The authors of “Communication Rehabilitation for Patients with Head and Neck Cancer Following Total Laryngectomy with Total Glossectomy” are Daniel W. Karakla, MD, Ann Cyptar, MS, CCC-SLP, Nicole McIntyre, MD, and J. Trad Wadsworth, MD, all from the Department of Otolaryngology – Head & Neck Surgery, Eastern Virginia Medical School, Norfolk, VA. They will present their findings at the 6th International Conference on Head and Neck Cancer being held August 7-11, 2004, at the Wardman Park Marriott in Washington, DC.
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