Rehabilitation of Laryngectomized Subjects

Abstract

Every laryngectomized person can be vocally rehabilitated. The eso-phageal voice is consciously trained; its physiology and rehabilitation were described by the author in 1924. To facilitate and enhance the voluntary production of an esophageal ructus, transnasal insufflation of air into the esophagus is used. At the same time the tension at the upper esophageal orifice is measured because of its prognostic significance. The lesser the pressure values obtained on insufflation of air into the esophagus, the better are the results of vocal rehabilitation. If the patient is unable to acquire a loud phonation, an electrolarynx is prescribed. The best results were achieved with the model manufactured by Western Electric and Bell, which permits changing of vocal pitch. Psychic rehabilitation is described and its importance stressed. Early removal of the cannula is recommended with a view to freeing the patient of feelings of disability. After partial laryngectomy or cordectomy, vocal training is introduced immediately on healing of the postoperative wound to achieve the development of a substitute vocal cord through the stimulating effect of vocal vibrations. The best functional results are obtained when using Sedlácěk's reconstruction of the vocal cord.