|
|
|
 |
|
| Laryngectomy |
|
Restoring Speech After Total Laryngectomy
After a total laryngectomy, you will not be able to speak using your
vocal cords. However, there are several options for restoring speech
after total laryngectomy. Losing your voice box to cancer no longer
means losing your ability to talk. Learning to speak again will take
time and effort. You will need to see a speech therapist who is trained
in the rehabilitation of people who have had a laryngectomy. The speech
therapist will play a major role in helping you to learn to speak.
Esophageal Speech
After a laryngectomy, your windpipe (or trachea) has been separated
from the mouth and food pipe, and therefore, you can no longer expel
air from the lungs through your mouth to speak. With training, some
patients can swallow air and force it through their mouth. As the air
passes through the throat it will cause vibrations which, with
training, people can turn into speech. This is the most basic form of
speech rehabilitation. With the advent of new devices and surgical
techniques, learning esophageal speech is often not necessary.
Tracheoesophageal Puncture (TEP)
This is the most common way that surgeons try to restore speech. TEP is
done either at the time of surgery or later. This procedure creates a
connection between the windpipe and food pipe through a small puncture
at the stoma site. A small one-way shunt valve placed into this
puncture restores your ability to force air from the lungs into the
mouth. After this operation, you can cover your stoma with a finger to
force air out of your mouth, producing sustained speech. This takes
practice, but after surgery you can work closely with speech
pathologists to learn this technique.
Electrolarynx
If you cannot have a TEP because of certain medical reasons, or while
you are learning to use your TEP voice, you may use electrical devices
to produce a mechanical voice. These battery-operated devices are
either placed in the corner of the mouth or against the skin of the
neck. When you press a button on the device, it will make a vibrating
sound. By moving your mouth and tongue, you can form this sound into
words. You will need training with a speech therapist to learn to use
it properly.
Stoma Care Following Total Laryngectomy
Having a stoma instead of a larynx means that the air you breathe in
and out will not pass through your nose or mouth. As air passes through
the nose or mouth, it is humidified, warmed, and filtered (dust and
other particles are removed). After a laryngectomy and tracheostomy,
the air reaching the lungs will be dryer and cooler. This may irritate
the lining of the breathing tubes and cause thick or crusty mucus to
accumulate.
For this reason, you should learn how to take care of your stoma
(periodic suctioning, cleaning, and use of a humidifier). Your doctors,
nurses, and other health care professionals can teach you how to care
for and protect your stoma, which includes precautions to keep water or
small particles from falling into the windpipe. Support groups formed
by other patients who have also had a laryngectomy can provide
essential information on stoma care and use of products for protecting
and cleaning the stoma.
Sexual Impact of Laryngectomy
Laryngectomy changes not only your physical appearance with the stoma
but also your speech and breathing. Sexual intimacy may be affected
because of uncomfortable feelings about appearance and awkwardness.
However, there are things you can do to decrease these feelings during
intimacy.
A scarf, ascot, or turtleneck shirt can look nice and hide the stoma
cover. Even during sexual activity, a stoma cover may look more
appealing than a bare stoma.
During sexual activity, a partner may be startled at first by breath
that hits at a strange spot. On the positive side, one patient quipped,
"Now when I kiss, I never have to come up for air!"
You can lessen odors from the stoma by avoiding garlic or spicy foods
and by wearing perfume, cologne, after-shave, or lotion.
Sometimes problems in speaking interfere with the communication for
some couples. If you have learned esophageal speech, talking during
lovemaking is not a big problem. It does take more effort, though, and
you lose some of the emotional overtones. A speech aid built into the
stoma might also work well. However, neither method lets you whisper
romantically in your partner's ear.
If you use a hand-held speech aid, communication during sex is likely
to be awkward and distracting. You can say a great deal sexually,
however, by guiding your partner's hand or using body language.
Talking is not needed in many sexual situations. With a new partner,
you may want to discuss the kinds of touching and positions you like
before you start making love.
Last Medical Review: 05/14/2007
Last Revised: 05/14/2007
|
|
|
|
|
