To provide a perspective of contemporary practice in rehabilitation of speech and swallowing in patients undergoing total laryngectomy in Australia.
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.
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: firstname.lastname@example.org