Novel method for the rehabilitation of the voice of patients who have undergone laryngectomy

The voice laboratory at the University of Navarre University Hospital has designed a novel and efficient protocol to evaluate and rehabilitate the voice of patients who have undergone laryngectomy. This involves a monitoring procedure based on patterns of phonatory flow. The study forms part of the PhD thesis by Dr Francisco Vázquez de la Iglesia. The title of the work is “Physiological Bases of the Pharyngoesophageal Segment. Characterisation of the erigmophonic voice as a function of its acoustic and aerodynamic parameters”.

Total laryngectomy is a surgical technique involving the radical extirpation of the larynx in patients suffering from advanced-stage cancer. According to Dr Vázquez, “these patients lose their capacity for oral communication, which greatly influences their quality of life. The most usual procedure for recovering the voice is the use of the esophagic voice. However, there is no diagnostic procedure enabling us to assess this quality of voice or that provides concrete rehabilitation measures that help to improve it”.

Description

The voice laboratory at the Ear, Nose and Throat Department at Navarre University Hospital has designed a protocol based on acoustic and aerodynamic parameters involved in the esophagic voice. “We conceived and adapted a specific instrument which has enabled an objective exploration method which helps us to better understand the complex process of the esophagic voice. By means of spectrographic parameters (quality of voice) and quantitative (pressure, flow, frequency), we can objectively define the different types of esophagic voice and rehabilitate it by means of positive feedback systems”.

One of the main interesting things about this research work is its immediate application to clinical practice, suitable for both diagnosing alterations in the esophagic voice as well as facilitating its rehabilitation. Moreover, it can be used for application in other rehabilitation procedures such as phonatory prothesis, electrolarynx, or even a number of surgical procedures on the pharyngoesophageal segment.

According to Dr Vázquez, “all patients subject to a total laryngectomy can benefit from this instrumental method, but above all those who, despite speech therapy, do not obtain a suitable esophagic voice. Currently, up to 70% of these patients do not manage to speak with an optimum voice.”

In the study, 33 patients who had undergone laryngectomy participated.