5.1 Surgical Voice Restoration

power source filter

pulmonary, PE segment, mouth/lips

what?

placing a silicone voice prosthesis in TEP to allow airstream redirection when tracheostoma occluded

prosthesis system and why

oneway flap to allow airflow and prevent aspiration

what impacts voice acquisition (3)

surgical techn, use of reconstruction, prev radio/chemo

why popular with px? (2 with explanations)

most similar to laryngeal voice (acceptability), better intelligibility and voice quality (some volume changes able and steadier air stream for phrase length and rate)

voice quality (4)

determined by tone of vibrating neoglottis, hypotonic, hypertonic (course whisper), spasmodic

pre-surgery SLT role (1)

MDT and px selection

post-surgery SLT aim

make px proficient in maintaining and changing valve independently

post-surgery patient education (3)

stoma/valve care, techniques, psychosocial adjustment

MDT management (4)

dilation, botox (spasmodic voice), fillers (ineffective, loose TEP), antifungals (common, thrush)

stoma/valve care (4)

secretion management, cleaning, valve leak/dislodgment/protrusion, changing

technique (3)

stoma occlusion, coordinating breath, pressure/effort

intraoperative valve placement (4)

indwelling valve, earlier voice rehab starting, reduced hospital stay, unable to test open tract voice

indwelling vs outdwelling valve

changed at hospital / at home

post-surgery valve placement (3)

feeding tube required in interim, open tract voice ax, valve selection and sizing