Current Status of Voice Restoration after Total Laryngectomy – Tracheoesophageal Shunt Voice –

Abstract

In the treatment of advanced laryngeal or pharyngeal cancer, while progress has been made in larynx-sparing therapies such as chemoradiotherapy, induction chemotherapy, and partial laryngectomy, total laryngectomy still plays an important role in terms of local control and salvage surgery. The importance of rehabilitation after total laryngectomy has been recognized. Regarding voice substitution, it is important to select the most appropriate means in accordance with the patient’s social background and wishes, and we believe it is important that all facilities offer patients equal opportunities to choose. Although guidance on esophageal speech is often mainly provided by patient groups, it is becoming increasingly important to build partnerships not only with physicians but also with speech-language pathologists, nurses, physicians in charge of community medicine, caregivers, social workers, etc., in order to perform shunt speech. We believe that by successfully coordinating with multiple professions and reducing the burden on physicians, it will be possible to provide voice restoration in accordance with the patient’s wishes. We introduce the current status of voice restoration and explain the multidisciplinary efforts to select voice restoration in our department. We also discuss our attempts to provide voice therapy for patients with shunt dysphonia.