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I'm thinking about adding some information on the "Voice Prosthesis" section of the article "Voice Therapy". This section currently only includes one sentence stating what a voice prosthesis is. I would add information on who qualifies for this, the process, how a prosthesis may affect speech, and possible outcomes in relation to voice therapy.

Here are some of the sources that I would draw from (found through ASHA):

- http://leader.pubs.asha.org/article.aspx?articleid=2291696

- http://sig3perspectives.pubs.asha.org/article.aspx?articleid=1777070

- http://www.asha.org/public/speech/disorders/tracheostomies/

Voice management after laryngectomy

  1. Some laryngectomized patients may succeed in achieving communication through the use of esophageal speech, in which air is swallowed, then gradually released while producing speech.[1]
  2. Others may make use of an electrolarynx (external vibrating device), which produces vibrations in the patient's oral cavity that they can no longer produce themselves without air passing through their vocal folds[2]
  3. The current medical standard after a laryngectomy is a tracheoesophageal puncture, which includes the insertion of a voice prosthesis.

Voice therapy with prostheses

A voice prosthesis is an artificial device, usually made of silicone, that is used to help laryngectomized patients speak. A tube is inserted into the neck, below the vocal folds, allowing air to go through the tube instead of through the mouth and nose.[3] Following a total laryngectomy, air will no longer pass through the vocal folds, significantly altering the person's ability to communicate orally.[3] In some instances, the person may be able to block the tube with their fingers and breathe as they did before the surgery or attach a valve to their tube, which serves to allow air to enter while preventing food from passing into the windpipe. In others, this is not a viable option due to resistance, infection, and insufficient air.[3] Voice therapy may then be turned to as a means for a person to regain the ability to communicate orally. Voice prostheses and ventilators may affect the volume of the speaker and the overall quality of the speaker's voice.[3] With the help of voice therapy as well as possible adjustments to ventilator settings, the goal is to become accustomed to using the device functionally and to learn the techniques and skills needed to sufficiently participate in daily communication.[4]

Other types of speech and language therapy after laryngectomy: Communication strategies

If the person is using a ventilator with their tube, there are long pauses between cycles of the ventilator. During these moments of silence, someone else may begin to speak, thus taking away the turn of the person with a ventilator. The person who has undergone a laryngectomy can use tools and techniques, such as those provided by a Speech-Language Pathologist (SLP) to self-advocate during conversations, in order to ensure that they are given the space that they need to participate in conversation. An SLP can also provide information to the person and to the people who interact with them frequently on communication strategies that would benefit them.

  1. ^ Tang, Christopher G.; Sinclair, Catherine F. "Voice Restoration After Total Laryngectomy". Otolaryngologic Clinics of North America. 48 (4): 687–702. doi:10.1016/j.otc.2015.04.013.
  2. ^ Tang, Christopher G.; Sinclair, Catherine F. "Voice Restoration After Total Laryngectomy". Otolaryngologic Clinics of North America. 48 (4): 687–702. doi:10.1016/j.otc.2015.04.013.
  3. ^ a b c d "Speech for People With Tracheostomies or Ventilators". www.asha.org. Retrieved 2017-10-13.
  4. ^ (ASHA), American Speech-Language-Hearing Association (2004). "Preferred Practice Patterns for the Profession of Speech-Language Pathology". www.asha.org. doi:10.1044/policy.PP2004-00191. Retrieved 2017-10-13.