Reasons for success or failure in surgical voice restoration after total laryngectomy: an Australian study

Over the past 20 years, use of tracheo-oesophageal puncture (TEP) speech af ter total laryngectomy has resulted in reported success rates of 90-93 per cent worldwide. Despite this, data collected from major acute hospitals in Victoria, Australia indicated that, of 38 patients who underwent total lary ngectomy in 1997, only 10 (26 per cent) were using TEP speech as their prim ary mode of communication at 12 months post-operatively. This paper describ es how a quantitative research methodology was used to investigate why so f ew patients in Victoria were successfully using TEP speech as their chosen mode of rehabilitation after total laryngectomy. Patients, speech pathologi sts and ENT surgeons were interviewed. Their thoughts and beliefs regarding speech rehabilitation were mapped, and themes were identified, coded and a nalysed. This paper describes and discusses the results of this research an d its possible implications for future patient management, through establis hing a model for 'ideal' speech rehabilitation.