Research Paper: Surgical Options for Post-Larengectomy

Sample Research Paper

Words 2,310

This is a research paper on surgical options for post-larengectomy. When the tracheotomy is occluded (with the patient’s thumb or a stoma valve) expiratory air is redirected to vibrate the muscles of the pharyngo-oesophageal sphincter to produce an “alaryngeal” voice.

Explain TEP speech and how the voice prosthesis works

When the tracheotomy is occluded (with the patient’s thumb or a stoma valve) expiratory air is redirected to vibrate the muscles of the pharyngo-oesophageal sphincter to produce an “alaryngeal” voice.  The vibrating sound travels directly into the oral cavity, where it is shaped by the articulators into speech sounds.  A one-way air valve of appropriate size and diameter is inserted to maintain the patency of the tracheo-oesophageal fistula.  A duckbill or trapdoor arrangement at the distal (oesophageal) end of the valve prevents food entering the trachea via the valve.  (Carding, 2001, p 298)

Advantages of TEP

The tracheoesophageai-esophageal shunt (TES) technique (Amatsu, 1978, 1980) enables the patient to use air from the trachea. This can be accomplished by connecting the trachea and the upper part of the esophagus. This surgical technique appears to offer a better voice quality (Johns & Cantrell, 1981; Wetmore, Krueger, & Wesson, 1981) and a general listener preference (Clark & Stempie, 1982) than the traditional esophageal voice. In addition, acoustic analysis has suggested that the TES voice is more intense and exhibits more stability in fundamental frequency than esophageal voice (Robbins, 1984; Rob-bins et al., 1984). Doyle et al. (1988) compared patients with TES and esophageal patients using nonsense stimuli. The parameters analyzed were overall consonant intelligibility, voicing, manner, and consonant omissions.

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