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 after 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 laryngectomy in 1997, only 10 (26 per cent) were using TEP speech as their primary mode of communication at 12 months post-operatively. This paper describes how a quantitative research methodology was used to investigate why so few patients in Victoria were successfully using TEP speech as their chosen mode of rehabilitation after total laryngectomy. Patients, speech pathologists and ENT surgeons were interviewed. Their thoughts and beliefs regarding speech rehabilitation were mapped, and themes were identified, coded and analysed. This paper describes and discusses the results of this research and its possible implications for future patient management, through establishing a model for ‘ideal’ speech rehabilitation.

[1]  H. Seikaly,et al.  Communication after laryngectomy. An assessment of patient satisfaction. , 1997, Archives of otolaryngology--head & neck surgery.

[2]  I. Ajzen,et al.  Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research , 1977 .

[3]  Charles D. Barrett.  Understanding Attitudes and Predicting Social Behavior , 1980 .

[4]  M. Singer,et al.  An Endoscopic Technique for Restoration of Voice after Laryngectomy , 1980, The Annals of otology, rhinology, and laryngology.

[5]  A. Strauss,et al.  The discovery of grounded theory: strategies for qualitative research aldine de gruyter , 1968 .

[6]  M. Singer,et al.  Further Experience with Voice Restoration after Total Laryngectomy , 1981, The Annals of otology, rhinology, and laryngology.

[7]  I. Ajzen,et al.  Understanding Attitudes and Predicting Social Behavior , 1980 .

[8]  M. Singer,et al.  A comparative acoustic study of normal, esophageal, and tracheoesophageal speech production. , 1984, The Journal of speech and hearing disorders.

[9]  A. Perry,et al.  Evaluation of functional outcomes (speech, swallowing and voice) in patients attending speech pathology after head and neck cancer treatment(s): development of a multi-centre database. , 2000, The Journal of laryngology and otology.

[10]  C. Silverman,et al.  The outcome and techniques of primary and secondary tracheoesophageal puncture. , 1994, Archives of otolaryngology--head & neck surgery.

[11]  S. Satya‐Murti.  Evidence-based Medicine: How to Practice and Teach EBM , 1997 .

[12]  H. Levine,et al.  Tracheoesophageal Puncture for Alaryngeal Voice Restoration , 1981, The Annals of otology, rhinology, and laryngology.

[13]  V. Minichiello.  In-depth Interviewing: Researching People , 1992 .