POSTLARYNGECTOMY VOICE RESTORATION - A 2-YEAR REVIEW

We present a e-year (1991/92) review of tracheooesophageal speech foll owing total laryngectomy with tracheo-oesophageal fistula formation an d subsequent use of a voicing prosthesis. Thirty-five primary fistulas and four secondary fistulas were created. Initially, 86% of patients obtained daily use of intelligible, fluent voice with few extraneous s tomal sounds. Over a 2 - 3-month period following surgery, approximate ly one-third of these lost their fistula speech. The reasons for this were mainly related to psychological and socio-economic factors. Patie nt selection, surgical technique and postoperative management are desc ribed. Although a successful outcome requires a consolidated team appr oach, primary health care workers also need to know about postlaryngec tomy prosthetic (fistula) speech and its management.