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Practice of laryngectomy rehabilitation interventions: a perspective from South America

Vartanian, José Guilhermea; Carrara-de-Angelis, Elisabeteb; Kowalski, Luiz Pauloa

Current Opinion in Otolaryngology & Head and Neck Surgery: June 2013 - Volume 21 - Issue 3 - p 212–217
doi: 10.1097/MOO.0b013e328361067b

Purpose of review Treatment of laryngeal cancer will depend on several factors, including tumor factors, patient factors, as well as the technical resource and expertise of the surgical team and treatment center. In developing countries, most patients have their diagnosis performed at advanced stages, with a significant proportion at very advanced locoregionally, which results in a limitation to the use of organ-preserving approaches. A total laryngectomy is still the most frequent treatment for larynx cancer patients. The rehabilitation in such scenarios can be more demanding and can cost more compared with developed countries.

Recent findings For early-stage tumors, function-preserving strategies are mandatory, and can include partial laryngectomies and radiation therapy. In such cases, functional rehabilitation usually is easily achieved, with lower negative impact on the patient's daily life. For advanced tumor stages, a treatment shift toward a more conservative management has been observed. However, the success rates of organ-preserving strategies, mainly with chemoradiation approaches, will rely on a rigorous patient selection process.

Summary The rehabilitation of laryngectomy patients in developing countries can be more demanding and can cost more compared with developed countries. In such scenarios, some strategies can be employed by the multidisciplinary team, mainly by the surgical and speech-pathology teams, aiming to decrease the costs involved in the rehabilitation of total laryngectomy patients in developing countries.

aHead and Neck Surgery and Otorhinolaryngology Department

bVoice, Speech and Swallowing Rehabilitation Department, Hospital A.C. Camargo, Sao Paulo, Brazil

Correspondence to Luiz Paulo Kowalski, MD, PhD, Head and Neck Surgery and Otorhinolaryngology Department, Hospital A.C. Camargo, Rua Professor Antonio Prudente, 211, 01509900 Sao Paulo, Brazil. Tel: +55 11 2189 5172; e-mail:

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins