Laryngectomy Flashcards Preview

Audiology and ENT Yr2 > Laryngectomy > Flashcards

Flashcards in Laryngectomy Deck (37)
Loading flashcards...
1
Q

What is a total laryngectomy?

A

Surgery to remove the larynx.

2
Q

What would only remove part of the larynx?

A

A partial laryngectomy.

3
Q

In laryngectomy what is swung up to the surface of the neck?

A

The trachea.

4
Q

Where do laryngectomy patients breathe from?

A

The stoma on their neck.

5
Q

in laryngectomy the functions of the _____ are also lost.

A

nose.

6
Q

What role would the nose have normally?

A
  • To humidify, filter and heat the air.

- Give a sense of smell.

7
Q

How can laryngectomy patients moisten and warm the air they breathe in?

A

Using an HME. Heat and Moisture Exchangers worn in front of the stoma.

8
Q

What has recently been developed?

A

hands free speech

9
Q

What is hands free speech?

A

special devices and attachments have been developed that make it possible to use the voice prosthesis without having to occlude the stoma by hand.

10
Q

Name the 3 voicing methods that can be learned after surgery.

A
  • Oesophageal Speech
  • Electrolarynx
  • SVP (Surgical Voice Prothesis) aka. tracheoesophageal voice
11
Q

___________voice is the most common speaking method and considered to be the most successful.

A

Tracheoesophageal.

12
Q

What type of voice does tracheoesophageal create?

A

It creates the most natural sounding, fluent, and easiest to understand kind of voice

13
Q

How is tracheoesophageal speech achieved?

A

a voice prosthesis is placed in a small opening between your windpipe and food tube (speech valve).

14
Q

Why do people have to have a laryngectomy?

A

-As a result of head & neck cancer or laryngeal cancer.

15
Q

Why is the cancer in the larynx quite contained?

A

As it is a cartilaginous structure.

16
Q

Apart from layngectomy what other treatments can be used? (or combined w/ it)

A

Radiotherapy

Chemotherapy

17
Q

how is the speech valve used to let patients to speak?

A

Air is pushed through with the finger, and muscles we use to burp are used to produce speech.

18
Q

Name the electronic device that can be used for voicing.

A

Electrolarynx.

19
Q

What is an electrolarynx?

A

a device you place on your neck and when you press a button it vibrates and generates an electronic sound that serves as your voice.

20
Q

What is oesophageal speech?

A

press small amounts of air from your mouth into your food tube and “belch” the air up aka. burp

21
Q

what is a limit to oesophageal speech?

A

Phrase length- can only manage 2/3 words at a time.

22
Q

What are some limits to the electrolarynx?

A
  • Pitch and Volume (sounds unnatural- but getting better w/ technology)
  • Position (sometimes difficult to find a spot where it works)
  • Aesthetics (quite electronic sounding, stigma of robotic voice etc.)
23
Q

In terms of SVP, what is primary puncture?

A

The voice prothesis is placed during the same surgery to create the tracheoesophageal puncture.

24
Q

Name this;

The voice prothesis is fitted several weeks after tracheoesophageal puncture.

A

Secondary puncture.

25
Q

What is better?

-primary or secondary puncture? and why?

A

Primary

  • early familiarity with voice prosthesis
  • get used to maintenance,
  • can start immediate voice rehabilitation after healing
  • related social benefits

Therefore it allows faster and more successful
postoperative voicing when compared to secondary fitting.

26
Q

Name 2 types of voice prothesis.

A

Blom

Provox.

27
Q

Out of Brom and Provox, what one tends to be better?

A

Provox

less leakage, dislodgement, better quality of voice production, better pateient compliance in maintaining the prothesis.

28
Q

Name some common problems with SVP.

A
  • Valve failure can cause central or peripheral leak.
  • Has limited lifespan of 3/4 months- has to be replaced
  • Acid reflux can destroy the silicon.
  • Can become infected
  • can cause candidiasis (thrush)
29
Q

What is the difference between a central leak and a peripheral leak?

A
central= leakage in the middle
peripheral = leakage round the sides
30
Q

What are some signs of valve failure?

A
  • coughing when eating and drinking

- voice become gugrly

31
Q

What stops food and drink leaking out when eating?

A

A flapper (kinda like epiglottis).

32
Q

Why do larygectomy patients have to have HMEs?

A

Heat and Moisture Exchange systems act as the nose- moisten and warming the air in preparation to get to the lungs.

33
Q

What can’t larygectomy patients do?

A

They can’t smell.

34
Q

_______ are replaced 3-5 times a day.

A

HMEs

35
Q

SLTs have a role in _______.

A

Rehab.

36
Q

In the future it is hoped that…

A

new technology and equipment are brought out.

37
Q

The handsfree kit clips into baseplate/larybutton- what does it allow?

A

It allows voicing without having to cover the stoma- can give patients more freedom, feeling of being normal again etc.