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Laryngectomy Counseling

last modified on: Thu, 12/07/2023 - 11:21

return to: Total Laryngectomy

Laryngectomy Home Care Booklet

Tracheoesophageal Puncture


Description of Tracheostomy Tubes and Appliances

Sample note generated after speech pathologists discussion re: "Life as a Laryngectomee" 

Mr. ___ was seen in clinic this morning for education and counseling regarding life as a laryngectomee. His wife and son were present and actively participated.  
Using multiple diagrams baseline head and neck anatomy and physiology was compared to post-laryngectomy anatomy and physiology. Special attention was drawn to the loss of ability to produce laryngeal voice/speech, loss of smell, loss of air humidification and filtration, importance of precautions around water, the benefits of using a foam stoma filter, and potential swallowing difficulties. Discussion was carried out regarding the pros and cons of the most common methods/devices for alaryngeal speech: electrolarynx, esophageal speech, Ultra Voice system, and tracheo-esophageal voice prosthesis. The patient viewed a video segment demonstrating speech using a tracheo-esophageal voice prosthesis. He was advised that patients at UIHC are typically not evaluated for creation of a tracheoesophageal fistula until a minimum of 3-4 months following total laryngectomy. Speech at the discourse level with an electrolarynx was demonstrated by this clinician. Demo shower shields and stoma filters were made available for the patient to inspect. Patient and family questions were then answered to their satisfaction.

Return to work after total laryngectomy -- sample note

“Mr.>>>>> has had a total laryngectomy and will have difficulty communicating verbally until he has mastered the electrolarynx (or Tracheoesophageal puncture speech or other alternative means of communication) -- he also has a permanent opening in his neck for breathing (tracheostome). This opening needs to be protected from drying effect as well as exposure to dust and fumes. His capacity to sense odors has also been compromised by limited flow of air through his nose. He should avoid situations where immersion in water is possible. Successful attention to these potential impediments should permit him to return to work.”