Author/Editor		Fajdiga, Igor; Hočevar-Boltežar, Irena; Žargi, Miha
Title		Voice prostheses - ten years after
Translated title		Traheoezofagalne govorne proteze, izkušnje desetih let
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 71, št. Suppl 3
Publication year		2002
Volume		str. III-85-8
Language		eng
Abstract		Since the introduction of tracheoesophageal puncture method by Bloom and Singer in 1980, the success of restoring vocal communication in laryngectomees has improved significantly. At the University Department of Otorhinolaringology and Cervicofacial Surgery in Ljubljana, the method has been used since 1993. We have performed 76 secondary tracheoesophageal punctures in patients with no objective contraindications and with an interest for this method. The success rate was 92%. With regard to our 10-years experience, we wanted to (re) define present and future role of tracheoesophageal voice/speech in the alaryngeal voice rehabilitation. To compare both alaryngeal speech modes, 32 patients using tracheoesophageal speech and 35 patients using esophageal speech were included into the study. In both groups the patients were established speakers. The complications that occurred in the patients with voice prostheses are presented. Most of them required only replacement of prostheses for their solution. The tracheoesophageal puncture and voice prosthesis insertion is a reliable and fast way of restoring good voice and speech after laryngectomy. In spite of some objective disadvantage in comparison to esophageal speech-like the use of hand, need for regular maintenance, and relying to medical service, its good characteristics should rank it immediately after a good esophageal speech. This means that tracheoesophageal voice prostheses should be offered to all patients, which are not able to learn a good esophageal voice in short time, to avoid a frustrating time with no vocal communication. After tracheoesophageal puncture and voice prosthesis insertion, the patient should still get a possibility to learn esophageal speech if he wants to avoid the drawbacks of the tracheoesophageal speech.
Summary		Z uporabo traheoezofagalnih govornih protez, ki sta jih uvedla Singer in Blom leta 1980, se je povrnitev govornega načina sporazumevanja po odstranitvi grla pomembno izboljšala. Na Kliniki za otorinolaringologijo in cervikofacialno kirurgijo v Ljubljani jih uporabljamo od leta 1993. Vstavili smo jih 76 izbranim bolnikom, ki niso imeli objektivnih zadržkov in so pokazali zanimanje za ta način govora. Vse smo vstavili naknadno po laringektomiji. Uspeh je bil 92%. Po 10 letih smo želeli (na novo) opredeliti pomen govornih potez pri povrnitvi govora po odstranitvi grla. Primerjali smo 34 bolnikov, ki govore s pomočjo govorne proteze s 35 bolniki, ki uporabljajo ezofagalni govor. Predstavili smo tudi zaplete, ki so povezani z govornimi protezami. Pri večini je bilo za njihovo rešitev potrebna le menjava proteze. Traheoezofagalne proteze hitro in zanesljivo povrnejo dober glas/govor po odstranitvi grla. Čeprav ima govor z govornimi protezami, v primerjavi z ezofagalnim govorom, določene pomanjkljivosti, kot npr. uporaba roke za govor, dnevno vzdrževanje proteze in odvisnost od zdravstvene oskrbe, ga moramo zaradi njegovih glasovnih kvalitet uvrstiti takoj za dobrim ezofagalnim govorom. To pomeni, da bi morali ta način govorne rehabilitacije ponuditi vsem bolnikom, ki ne uspejo hitro osvojiti dobrega ezofalnega govora. S tem bi se predvsem izognili mučnemu obdobju brez govornega sporazumevanja. Po vstavitvi govorne proteze pa bi morali bolniku še vedno ponuditi možnost, da se nauči ezofagalnega govora, če bi ga pomanjkljivosti traheoezofagalnega govora motile.
Descriptors		LARYNGECTOMY LARYNX, ARTIFICIAL SPEECH, ESOPHAGEAL VOICE QUALITY SPEECH ACOUSTICS