Surgical voice restoration following ablative surgery for laryngeal and hypopharyngeal carcinoma

Surgical voice restoration is an important part of functional rehabilitatio n of patients following ablative surgery for laryngeal and hypopharyngeal c arcinoma. The aim of this retrospective study was to assess the functional status with regard to speech of a cohort of 100 patients (age ranged 34-84 years), who underwent laryngectomy and laryngopharyngectomy over a 10-year period (1989-1999). Ninety-two patients consented to surgical voice restoration. Primary trache oesophageal punctures were performed in 70 and secondary punctures in 22 (m ainly after jejunal flap reconstruction). Nine patients were excluded from this analysis (seven patients died prior to assessment, one had the prosthe sis removed at her request and one patient had insufficient follow-up). Tra cheoesophageal speech was assessed in the remaining 83 patients using a rat ing scale measuring the number of syllables per breath, use of voice and in telligibility by non-professional listeners. Currently, Provox 2 valves are being used in the majority of patients. Overall tracheoesophageal speech r esults were good in 45/83 (54.2 per cent), average in 22/83 (26.5 per cent) and poor in 15/83 (18 per cent). One patient could not develop tracheoesop hageal speech. The majority of laryngectomy patients had good speech but in patients who had complex reconstructions tracheoesophageal speech was most ly rated as average. Average to good speech in more than two-thirds of the cohort of patients sh ow that surgical voice restoration is a highly successful and valuable tech nique to restore speech functions after ablative surgery for laryngeal and hypopharyngeal carcinoma.