BLOM-SINGER PROSTHESES - AN 11 YEAR EXPERIENCE OF PRIMARY AND SECONDARY PROCEDURES

Over the past 11 years, 25 primary and 29 secondary tracheo-oesophagea l punctures have been performed in 51 laryngectomees. Pre-operative as sessment is required for the secondary procedure. Both primary and sec ondary procedures require intensive speech therapy after fitting of th e prosthesis. Fifty-four per cent of the primary and 37% of the second ary patients attained long-term speech, the latter figure rising to 58 % with newer valves and increasing experience. Failures were commonly due to psychological or prosthesis-related problems. Complications wer e relatively minor, none being life threatening. Seventy per cent of t he long-term users were self caring. Adequate rehabilitation counselli ng and support is necessary to ensure long-term use of the prosthesis.