Current Trends in Laryngectomy Rehabilitation: A Survey of Speech-Language Pathologists

1998 ◽  
Vol 118 (4) ◽  
pp. 458-463 ◽  
Author(s):  
Gerald L. Culton ◽  
John M. Gerwin
Keyword(s):  
Speech Production ◽  
Speech Therapy ◽  
Voice Prosthesis ◽  
Sample Population ◽  
Speech Language Pathologists ◽  
Speech Rehabilitation ◽  
Current Trends ◽  
Tracheoesophageal Puncture ◽  
Therapy Sessions ◽  
Production Problems

This study determined the perceptions of experienced speech-language pathologists regarding current practices in the speech rehabilitation of laryngectomy patients since the introduction of the tracheoesophageal puncture-voice prosthesis technique in 1980. The sample population consisted of 151 experienced speech-language pathologists, or 43% of those who were sent questionnaires. The speech-language pathologists ranked tracheoe-sophageal puncture-voice prosthesis as their most preferred speech rehabilitation method and the electrolarynx as their least preferred, even though the electrolarynx continues to be the most frequently used method. Variable use of the tracheoesophageal puncture procedure by otolaryngologists was reported, with only a small portion perceived as using it routinely. About 65% of the speech-language pathologists reported that more than half of the laryngectomy patients were being given choices among speech rehabilitation methods. Nearly 50% of the speech-language pathologists reported that fewer than six speech therapy sessions were necessary with tracheoesophageal puncture patients, whereas more than 20% reported the need for 10 sessions or more. Use of manual closure of the tracheostoma by tracheoesophageal puncture patients far outweighed their use of automatic speaking valves. Most speech-language pathologists reported that they were involved in teams with otolaryngologists to determine patient suitability for tracheoesophageal puncture and to troubleshoot problems. Eighteen different categories of medical and speech production problems were reported.

Applications of the Voice Prosthesis during Laryngectomy

1989 ◽  
Vol 98 (12) ◽  
pp. 921-925 ◽  
Author(s):  
Mark I. Singer ◽  
Eric D. Blom ◽  
Ronald C. Hamaker ◽  
Glen Y. Yoshida
Keyword(s):  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Alaryngeal Speech ◽  
Recent Introduction ◽  
Speech Rehabilitation ◽  
Tracheoesophageal Puncture ◽  
The Voice

With the recent introduction of the voice prosthesis for alaryngeal speech rehabilitation, its application in the early postlaryngectomy period is gaining acceptance. One hundred twenty-eight patients received a tracheoesophageal puncture and adjunctive pharyngeal constrictor relaxation during laryngectomy. The voice prosthesis was applied as early as 10 days after surgery, and the results of a 9-year experience are presented. Eighty percent of the population achieved a durable voice, and the complications were infrequent. The results support the primary use of tracheoesophageal phonation as a relatively safe and reliable alternative to total laryngectomy alone.

scholarly journals Clinical Localization of the Spasmodic Segment in Voice Limiting Pharyngoesophageal Spasm

2010 ◽  
Vol 1 (3) ◽  
pp. 189-192
Author(s):  
Rao Vishal ◽  
Anil K D'Cruz ◽  
Mandar Deshpande ◽  
Devendra Chaukar ◽  
Prathamesh Pai
Keyword(s):  
Total Laryngectomy ◽  
Speech Therapy ◽  
Postoperative Radiotherapy ◽  
Cervical Region ◽  
Clinical Tool ◽  
Pharyngoesophageal Segment ◽  
Speech Rehabilitation ◽  
The Mean ◽  
Tracheoesophageal Puncture ◽  
Carotid Vessels

Abstract Background Primary tracheoesophageal prosthetic speech is the gold standard for speech rehabilitation in patients undergoing total laryngectomy. However, despite a high success rate, the speech outcome can be suboptimal in 5-15% of these patients. The most frequent cause being hypertonicity of the pharyngoesophageal segment. We elaborate a simple clinical technique that can be performed in an outpatient clinic to identify the hypertonic pharyngoesophageal segment in patients with PES. Methods All these patients (13 males and 1 female) had undergone total laryngectomy and primary tracheoesophageal puncture followed by postoperative radiotherapy. Even after rigorous speech therapy, these patients had failed to develop fluent speech. The mean duration following surgery was 8 months (range 4-20 months). A simple clinical technique is elaborated utilizing the dermal ballooning effect observed in the cervical region to ascertain the site of pharyngo esophageal spasmodic segment. Results Using this technique we have been able to identify the hypertonic segment successfully in 13 of the 14 patients with PES. In these patients the trial lignocaine block was injected specifically at these points medial to the carotid vessels. Improvement in speech following the block was observed, and was further confirming using a videofluroscopy. Conclusion This technique serves as a simple and useful clinical tool to map the spasmodic segment and to guide the injection site for trial lignocaine block and as well for botulinum a toxin. In addition, it also prevents inadvertent injection to the normal segments.

Facilitating Parental Involvement in Speech Therapy for Children With Speech Sound Disorders: A Survey of Speech-Language Pathologists' Practices, Perspectives, and Strategies

2020 ◽  
Vol 29 (4) ◽  
pp. 1987-1996
Author(s):  
Sherine R. Tambyraja
Keyword(s):  
Parental Involvement ◽  
Online Survey ◽  
Speech Therapy ◽  
Speech Sound ◽  
Speech Sound Disorders ◽  
Speech Sound Disorder ◽  
Speech Language Pathologists ◽  
School Based ◽  
Homework Completion

Purpose This study investigated the extent to which speech-language pathologists (SLPs) facilitate parents' completion of homework activities for children with speech sound disorder (SSD). In addition, this study explored factors related to more consistent communication about homework completion and strategies considered particularly effective for supporting this element of parental involvement. Method Licensed SLPs serving at least one child with SSD were invited to participate in an online survey. Questions relevant to this study gathered information regarding (a) frequency of communication about homework distribution and follow-up, (b) demographic and workplace characteristics, and (c) an open-ended question about the specific strategies used to support parental involvement and completion of homework activities. Results Descriptive results indicated considerable variability with respect to how frequently SLPs engaged in communication about homework completion, but that school-based SLPs were significantly less likely to engage in this type of follow-up. Strategies considered effective, however, were similar across therapy contexts. Conclusion These results suggest potentially important differences between school-based services and therapy in other contexts with respect to this particular aspect of service provision for children with SSD.

Periprosthetic Leakage in Tracheoesophageal Prosthesis: Proposal of a Standardized Therapeutic Algorithm

2021 ◽  
pp. 019459982098334
Author(s):  
Claudio Parrilla ◽  
Ylenia Longobardi ◽  
Jacopo Galli ◽  
Mario Rigante ◽  
Gaetano Paludetti ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Retrospective Cohort ◽  
Voice Prosthesis ◽  
Management Algorithm ◽  
Therapeutic Algorithm ◽  
Periprosthetic Leakage ◽  
Tracheoesophageal Puncture ◽  
The University ◽  
The Voice

Objective Periprosthetic leakage represents the most demanding long-term complication in the voice prosthesis rehabilitation. The aim of this article is to discuss the various causes of periprosthetic leakage and to propose a systematic management algorithm. Study Design Retrospective cohort study. Setting Otolaryngology clinic of the University Polyclinic A. Gemelli–IRCCS Foundation. Methods The study included 115 patients with voice prosthesis who were treated from December 2014 to December 2019. All patients who experienced periprosthetic leakage were treated with the same step-by-step therapeutic approach until it was successful. Incidence, management, and success rate of every attempt are analyzed and discussed. Results Periprosthetic leakage was reported 330 times by 82 patients in 1374 clinic accesses. Radiotherapy, timing of tracheoesophageal puncture, and type of total laryngectomy (primary or salvage) did not influence the incidence of periprosthetic leakage. Salvage total laryngectomy increases the risk of more clinically relevant leakages. Conclusion By using a systematic algorithm with a step-by-step standardized approach, periprosthetic leakage management could become a less treacherous issue.

Differences in Children’s Sound Production When Speaking With a Cochlear Implant Turned On and Turned Off

1996 ◽  
Vol 39 (3) ◽  
pp. 604-610 ◽  
Author(s):  
Nancy Tye-Murray ◽  
Linda Spencer ◽  
Elizabeth Gilbert Bedia ◽  
George Woodworth
Keyword(s):  
Cochlear Implant ◽  
Speech Production ◽  
Cochlear Implants ◽  
Sound Production ◽  
Proprioceptive Feedback ◽  
Speech Sample ◽  
Speech Language Pathologists ◽  
Monosyllabic Words ◽  
Consonant Voicing ◽  
Vowel Height

Twenty children who have worn a Cochlear Corporation cochlear implant for an average of 33.6 months participated in a device-on/off experiment. They spoke 14 monosyllabic words three times each after having not worn their cochlear implant speech processors for several hours. They then spoke the same speech sample again with their cochlear implants turned on. The utterances were phonetically transcribed by speech-language pathologists. On average, no difference between speaking conditions on indices of vowel height, vowel place, initial consonant place, initial consonant voicing, or final consonant voicing was found. Comparisons based on a narrow transcription of the speech samples revealed no difference between the two speaking conditions. Children who were more intelligible were no more likely to show a degradation in their speech production in the device-off condition than children who were less intelligible. In the device-on condition, children sometimes nasalized their vowels and inappropriately aspirated their consonants. Their tendency to nasalize vowels and aspirate initial consonants might reflect an attempt to increase proprioceptive feedback, which would provide them with a greater awareness of their speaking behavior.

Proof of Concept of a Tracheoesophageal Voice Prosthesis Insufflator for Speech Production After Total Laryngectomy

2017 ◽  
Vol 31 (4) ◽  
pp. 514.e1-514.e4
Author(s):  
Heather Starmer ◽  
Russell H. Taylor ◽  
Salem I. Noureldine ◽  
Jeremy D. Richmon
Keyword(s):  
Speech Production ◽  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Proof Of Concept

INDICATIONS FOR TRACHEOESOPHAGEAL PUNCTURE SPEECH REHABILITATION

1986 ◽  
Vol 96 (10) ◽  
pp. 1065???1068 ◽  
Author(s):  
FRED M. S. MCCONNEL ◽  
SIGSBEE W. DUCK
Keyword(s):  
Speech Rehabilitation ◽  
Tracheoesophageal Puncture

Conversion from a non-indwelling to a Provox®2 indwelling voice prosthesis for speech rehabilitation: comparison of voice quality and patient preference

2003 ◽  
Vol 117 (10) ◽  
pp. 815-820 ◽  
Author(s):  
A. C. Vlantis ◽  
R. T. Gregor ◽  
H. Elliot ◽  
M. Oudes
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Patient Preference ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Voice Prosthesis ◽  
Technical Aspects ◽  
Speech Rehabilitation ◽  
Perceptual Difference ◽  
The Voice

This prospective study assessed the advantages and problems associated with converting a patient using an older generation non-indwelling voice prosthesis to a newer generation indwelling voice prosthesis, in this case the Provox®2. The voice characteristics of each patient were measured using the old and then the new voice prosthesis. Technical aspects of the insertion of the indwelling prosthesis were noted. Each patient completed a questionnaire after a period of use with the indwelling prosthesis.Changing the prosthesis was simple and uncomplicated in 15 of 17 patients. Acoustic analysis showed improved parameters with the indwelling prosthesis, but no perceptual difference between the two prostheses. The questionnaire revealed that most patients preferred the indwelling prosthesis.Replacing a non-indwelling with an indwelling prosthesis is technically simple, leading to improvement in voice quality and patient satisfaction. It may be reasonable to offer this choice to patients currently using an older generation non-indwelling voice prosthesis.

scholarly journals Exploring the Overlap Between Dyslexia and Speech Sound Production Deficits

2018 ◽  
Vol 49 (4) ◽  
pp. 774-786 ◽  
Author(s):  
Kathryn L. Cabbage ◽  
Kelly Farquharson ◽  
Jenya Iuzzini-Seigel ◽  
Jennifer Zuk ◽  
Tiffany P. Hogan
Keyword(s):  
At Risk ◽  
Young Children ◽  
Speech Production ◽  
Sound Production ◽  
Speech Sound ◽  
Speech Sound Disorder ◽  
Speech Language Pathologists ◽  
Speech Language Pathologist ◽  
History Of ◽  
Production Errors

Purpose Children with dyslexia have speech production deficits in a variety of spoken language contexts. In this article, we discuss the nature of speech production errors in children with dyslexia, including those who have a history of speech sound disorder and those who do not, to familiarize speech-language pathologists with speech production–specific risk factors that may help predict or identify dyslexia in young children. Method In this tutorial, we discuss the role of a phonological deficit in children with dyslexia and how this may manifest as speech production errors, sometimes in conjunction with a speech sound disorder but sometimes not. We also briefly review other factors outside the realm of phonology that may alert the speech-language pathologist to possible dyslexia. Results Speech-language pathologists possess unique knowledge that directly contributes to the identification and remediation of children with dyslexia. We present several clinical recommendations related to speech production deficits in children with dyslexia. We also review what is known about how and when children with speech sound disorder are most at risk for dyslexia. Conclusion Speech-language pathologists have a unique opportunity to assist in the identification of young children who are at risk for dyslexia.

Characteristics of Speech Production after Tracheoesophageal Puncture

1986 ◽  
Vol 29 (4) ◽  
pp. 499-504 ◽  
Author(s):  
Joanne Robbins ◽  
John Christensen ◽  
Gail Kempster
Keyword(s):  
Motor Control ◽  
Speech Production ◽  
Voice Onset Time ◽  
Onset Time ◽  
Major Influence ◽  
Vowel Duration ◽  
Voice Production ◽  
Audio Recordings ◽  
Tracheoesophageal Puncture ◽  
Offset Time

Voice onset time (VOT) and vowel duration characteristics of speakers following the Singer-Blom technique of tracheoesophageal puncture (1980) were compared to those of traditional esophageal and laryngeal speakers. Fifteen subjects in each of the three speaker groups produced the words /pik/, /kup/, and /kup/ in a carrier phrase while audio recordings were obtained. Broadband spectrograms were made of the consonant-vowel-consonant (CVC) utterances and vowel duration and VOT were measured. Analysis of variance (ANOVA) procedures revealed that the tracheoesophageal speakers produced significantly shorter VOTs and longer vowel durations than the laryngeal speakers. However, the longer vowel durations for the traeheoesophageal speakers were not completely accounted for by the shorter VOTs found for that group. Spectrographic examination suggests that delayed voice offset time for the tracheoesophageal speakers also contributes to their longer vowel durations. Overall findings indicate that the physical characteristics and motor control properties of the neoglottis, even when driven by pulmonary air as in tracheoesophageal speakers, exert a major influence on alaryngeal voice production.

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