Laryngeal Cancer: Benefits of Speech-Language Pathology
Services
What does a speech-language pathologist (SLP) do when working
with individuals with laryngeal cancer?
The SLP will meet with the person and family before surgery.
The SLP will evaluate factors like vocal quality, pitch range,
and presence or absence of accent or regional speech variations.
This evaluation allows the SLP to understand the person's
speech and voice abilities. This understanding helps the SLP plan
treatment after surgery.
The SLP will also explain the anatomy and physiology of the
larynx, describe how surgery will change this, and provide
information on what will happen in the intensive care unit
immediately following the surgery.
The person will not have a voice after the larynx is removed.
The SLP will provide a pad of paper and a pen or another writing
device for expressing basic needs to nurses, doctors, family, and
friends immediately after surgery.
After surgery, the SLP's primary goal is to provide the
person with a new sound source for speech. There are three
primary options:
-
Esophageal Speech
: A person takes air in through the mouth, traps it in the
throat, and then releases it. As the air is released, it makes
the upper parts of the throat/esophagus vibrate and produces
sound that is shaped into words in the same way it was before
surgery: with the lips, tongue, teeth, and other mouth parts.
This type of
alaryngeal speech
is difficult to learn and use effectively, especially in rushed
or stressful communication situations.
-
Artificial Larynx
: The person uses an electronic or mechanical instrument that
provides the sound source for speech. Some of these devices are
held against the neck, and others have a tube that the patient
puts in his mouth. Many people use an artificial larynx as
their first means of alaryngeal speech. Effective use still
requires training and practice, and some disadvantages exist.
The artificial larynx has a mechanical voice quality, requires
the use of one hand, and draws attention to the speaker.
-
Tracheoesophageal Puncture (TEP)
: This surgical procedure is one of the more popular methods of
alaryngeal speech production. It can be performed at the time
of the laryngectomy surgery or afterwards. The surgeon creates
a connection between the trachea and the esophagus with a small
hole. A small, one-way shunt valve is then inserted into this
hole. To speak, the person inhales air through the stoma and
into the lungs. Then, he or she covers the stoma with a finger.
Air from the lungs is then directed from the trachea, through
the shunt valve, and into the esophagus. The esophagus
vibrates, creating a sound source for speech. This sound is
then shaped into speech sounds in the mouth in the same way it
was done before laryngectomy. The SLP will assist the
individual in selecting and fitting the prosthesis and can
teach proper prosthesis care and use.
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See Also:
Laryngeal Cancer
Laryngeal Cancer: Causes and Number