🧠 Carcinoma of the Larynx — Application & Scenario Q&A

Q1. A 58-year-old male who smokes and drinks daily reports persistent hoarseness for 3 weeks. What should the SLP recommend?

A. Refer to an ENT for laryngeal examination — early hoarseness may indicate glottic carcinoma.

Q2. A client with laryngeal cancer reports throat pain and ear pain. Why might this occur?

A. Referred pain through the vagus nerve (CN X), common in advanced laryngeal carcinoma.

Q3. After total laryngectomy, a patient expresses fear of “never speaking again.” How should the SLP respond?

A. Provide reassurance, explain voice options (TEP, electrolarynx, esophageal), and show videos of successful users.

Q4. During a session, your post-laryngectomy client’s prosthesis leaks fluid when drinking. What is the appropriate response?

A. Stop oral intake and notify the ENT—leakage means the TEP prosthesis needs replacement.

Q5. A client is frustrated learning esophageal speech due to limited phrase length. What alternative might you suggest?

A. Try tracheoesophageal (TEP) speech for easier pulmonary airflow and longer utterances.

Q6. A patient using an electrolarynx speaks too quickly, making speech hard to understand. What should therapy target?

A. Train slower rate, clear articulation, and natural pausing for improved intelligibility.

Q7. You are providing pre-operative counseling to a new laryngectomy patient. What visual or auditory tools can help understanding?

A. Use anatomical diagrams and videos showing post-surgery communication methods.

Q8. A client with supraglottic carcinoma has difficulty swallowing liquids. What are two possible reasons?

A. Tumor obstruction or reduced airway protection during the swallow.

Q9. A post-radiation patient reports dry mouth and difficulty swallowing. What SLP strategy can help?

A. Recommend frequent sips of water, saliva substitutes, and moist foods during meals.

Q10. A patient’s electrolarynx produces a muffled sound. What troubleshooting step should you take?

A. Re-position the device for better neck contact and adjust volume settings.

Q11. A patient says, “I feel embarrassed to talk in public with my new voice.” How should you respond?

A. Validate their feelings, offer counseling referrals, and include social communication practice in therapy.

Q12. During TEP training, your client struggles to coordinate breath support. What exercise can help?

A. Teach timing of exhalation before voicing and practice short phrases with controlled airflow.

Q13. A patient after partial laryngectomy presents with mild aspiration on thin liquids. What modification might you suggest?

A. Use thicker liquids, smaller sips, and chin-tuck posture to improve airway protection.

Q14. A laryngectomy patient points to their stoma and asks how to protect it when showering. What should you recommend?

A. Use a shower shield or stoma cover to prevent water from entering the airway.

Q15. A client’s electrolarynx battery frequently dies mid-session. What proactive teaching point can you offer?

A. Encourage carrying a backup battery and performing daily equipment checks.

Q16. A patient prefers not to handle devices or prosthetics. Which alaryngeal speech method might fit best?

A. Esophageal speech, since it requires no external equipment.

Q17. A TEP patient complains of gurgling sounds while speaking. What could this indicate?

A. Improper valve closure or residue buildup on the prosthesis—needs cleaning or replacement.

Q18. You are training a patient on electrolarynx use who has limited neck tissue from surgery. What adaptation could you use?

A. Use the intraoral adapter to transmit sound through the mouth instead of the neck.

Q19. During a support-group session, a new patient asks why their friend’s TEP voice sounds more natural. What’s the best explanation?

A. TEP speech uses lung air, giving more natural prosody than electrolaryngeal or esophageal speech.

Q20. A 62-year-old former singer after total laryngectomy asks if they can ever “sing again.” How can you frame your answer?

A. Explain that melody and rhythm can still be practiced with alternative voicing, but pitch range will be limited.