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Clinical Care and Rehabilitation in Head and Neck Cancer pp 163–187Cite as

Voice Restoration with the Tracheoesophageal Voice Prosthesis: The Current State of the Art

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Abstract

Since its introduction in 1980, the tracheoesophageal (TE) puncture voice restoration method has been shown to be a viable, effective method of speech rehabilitation after laryngectomy. Historically, high success rates have been reported for appropriately selected patients. Since the development of TE voice restoration, however, the laryngectomy population itself has changed dramatically. With the advent of “organ preservation” protocols as a treatment method for advanced laryngeal cancer, many individuals undergo laryngectomy as a secondary procedure after radiation or chemoradiation. As a result, postoperative complications are common, delaying speech and swallowing rehabilitation. Moreover, individuals who undergo complex surgical reconstruction in addition to total laryngectomy may be poorer candidates for a TE puncture. Navigating these issues can pose a challenge for the clinician with regard to determining candidacy, troubleshooting, and managing complications. This chapter will discuss these, as well as other issues, and provide an overview of the current state of the art of TE voice restoration.

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Notes

  1. 1.

    A note on terminology: Some authors prefer to use the abbreviation TEP or TEF to refer to the tracheoesophageal puncture or fistula tract and use the abbreviation VP to refer to the voice prosthesis. Commonly, however, the term TEP is also used to refer to the voice prosthesis, and this is true of the research literature, as well as clinical and commercial parlance. There can also be confusion between a surgically created and intentional “fistula” and one which occurs spontaneously and delays recovery. For clarity, therefore, we have used the term “VP” to refer to the voice prosthesis throughout this chapter. We have used “TE puncture” to refer to the surgically created tract in which the TEP sits and the term “fistula” is used only to refer to a wound breakdown resulting in an unwanted opening in the tissues of the head or neck.

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  1. Northwest Center for Voice and Swallowing, Department of Otolaryngology – Head & Neck Surgery, Oregon Health and Science University, Portland, OR, USA

    Donna J. Graville, Andrew D. Palmer & Rachel K. Bolognone

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  1. Donna J. Graville
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  1. Department of Otolaryngology Head and Neck Surgery and School of Communication Sciences & Disorders , Western University, London, ON, Canada

    Philip C. Doyle

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Graville, D.J., Palmer, A.D., Bolognone, R.K. (2019). Voice Restoration with the Tracheoesophageal Voice Prosthesis: The Current State of the Art. In: Doyle, P. (eds) Clinical Care and Rehabilitation in Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-04702-3_11

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