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Practice of laryngectomy rehabilitation interventions: a perspective from Australia

Krishnan, Surena,b; Maclean, Juliac

Current Opinion in Otolaryngology & Head & Neck Surgery: June 2013 - Volume 21 - Issue 3 - p 224–229
doi: 10.1097/MOO.0b013e32836118aa
SPEECH THERAPY AND REHABILITATION: Edited by H. Fiona Robinson

Purpose of review: To provide a perspective of contemporary practice in rehabilitation of speech and swallowing in patients undergoing total laryngectomy in Australia.

Recent findings: In Australia, the preferred method of voice rehabilitation is by the use of tracheo-oesophageal voice prosthesis. Dysphagia is an ongoing problem and the use of adjuvant radiation and chemotherapy compounds this problem. There are difficulties associated with surgery because of the variation in disease involvement of pharyngeal mucosa and musculature, as well as difficulties associated with healing in previously chemoradiated surgical fields.

Summary: This article demonstrates the need for careful consideration of surgical technique, particularly in closure of the neopharynx in the chemoradiated patient. It encourages further research into the problems of speech and particularly swallowing in this patient population, as these problems impact significantly on the quality of life.

aDepartment of Surgery, University of Adelaide

bDepartment of Otolaryngology, Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, South Australia

cSpeech Pathology, Cancer Care Centre, St George Hospital, Kogarah, Sydney, New South Wales, Australia

Correspondence to Suren Krishnan, OAM, FRACS, Chairman of Department of Otolaryngology, Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, SA 5000, Australia. Tel: +61 8 8258 1143; fax: +61 8 8281 2782; e-mail: suren@krishnanmedical.com.au

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins