Rehabilitacija glasa traheoezofagealnim govornim protezama nakon totalne laringektomije Voice restoraon using tracheoesophageal voice prostheses following total laryngectomy

Aim: Total laryngectomy is an expansive operaon and can be performed with or with- out neck dissecon. During this procedure the enre larynx is removed, the windpipe is brought out to the skin and secured there in the form of a permanent tracheostome. The most diffi cult aspect of laryngeal funcon to reconstruct, and the one to which most research is dedicated to is the reaain- ment of speech. The main opons for voice restoraon aer total laryngectomy are esophageal speech, electrolarynx speech, and tracheoesophageal speech. Tracheoesophageal puncture with prosthesis is currently the surgical method of choice for vocal restoraon aer total laryngectomy. This puncture tract can be created primarily, at theme of total laryngectomy, or secondarily, weeks or years following the laryngectomy. Paents and Methods: Between the period of 01.01.2004. and 31.12.2008., 125 laryngectomized paents have been rehabilitated at the Otorhynolaryngology De- partment of the Clinical Hospital Center Rijeka. The indicaon for total laryngectomy was T3 or T4 laryngeal carcinoma in 58 (46%) paents, and 67 (54%) paents underwent a paral laryngectomy. Results: The methods of voice rehabilitaon were tracheoesophageal speech (91%), esophageal speech (6%) and arfi cial larynx (3%). A voice prosthesis could be inserted in 49 paents by primary puncture, in 36 paents by secondary puncture. The median device lifeme was 7,9 months. 10 % of the prostheses were replaced with a lifeme of less than 3 months, 46% from 3 to 6 months, and 44% devices longer than 6 months. Conclusion: Eff ecve restoraon of voice is crical to enabling the paent to return to normal funconing in their life. Tracheoesophageal speech has become the method of choice for postlaryngectomy voice restoraon.