Frequently Asked Questions
Q: Will I be able to speak again?
A: Most laryngectomees are able to speak again, either with a voice prosthesis (tracheoesophageal puncture), or artificial larynx (electrolarynx) or esophageal speech. Your surgeon and/or speech therapist will explain these options to you. Many largyngectomees are people for whom "talking" is their business. They speak fluently and understandably with their new voices. All that is lost through surgery is the original source of voiced sound - the voice box (larynx). The lips, tongue, teeth and nasal passages, which are also essential for forming words, ordinarily remain as they were before surgery.
Q: Why did this happen to me?
A: No one knows why it happened to you, but you may wish to know that there are approximately 50,000 laryngectomees (persons who have had their larynx removed) in the United States. Research has indicated that smoking is one of the leading causes of laryngeal cancer, but there are a number of other factors that may also contribute to the diagnosis.
Q: Is this a serious operation?
A: It is as serious as any other major operation, but modern techniques of surgery, anesthesia, use of antibiotics and skilled nursing care makes it relatively safe today.
Q: Will I be able to work again?
A: Many laryngectomees have returned to their former jobs. The answer depends on
many factors: your age, your health and the type of work you have been doing.
The most important factor is YOU - your determination to recover and do what you feel is best for YOU.
Q: Why is an opening in the neck necessary?
A: Before surgery, breathing and food passages have a common passage in the
throat; further down they divide into the trachea (windpipe) for breathing and the esophagus (gullet) for carrying food to the stomach. If the voice box (larynx), which controls entry of air into the trachea, is surgically removed (laryngectomy), it is then necessary to relocate the end of the air passage as an opening at the front of the neck. This is called the stoma.
Q: Will I always have to breathe through this opening?
A: Yes, this is your new airway and you will breathe as naturally as you always have without thinking about it. You may initially have a lot of mucous and coughing, but you will see at laryngectomee meeting that others cough no more often than persons who have a larynx.
Q: Why should the stoma be covered?
A:
A. For hygienic reasons: since the air is no longer filtered or warmed by the nasal passages, foreign matter such as dust or clothing particles, and even air of a different temperature may irritate the sensitive walls of the air passage trachea).
B. To help keep in moisture: when we exhale, we release moisture from the lungs. By covering the stoma, we help to keep that moisture in the airway, easing breathing and reducing the need to cough.
C. For personal appearances: an opening in the neck, exposed for all to see, may cause unnecessary surprise and discomfort to friends and strangers.
Q: How can I cover the stoma?
A: The simplest arrangement is to wear a cotton stoma cover tied behind the neck.
Also, foam squares with adhesive may be used after your neck is healed. Both
help create moisture in the airway and are worn comfortably under clothing.
Q: When does speech therapy begin?
A: Your surgeon will decide this. An electrolarynx may be safely introduced, with
the use of an oral adaptor, while you are hospitalized. Use of esophageal speech or speech via a TEP may require more healing.
Q: When will I be able to speak?
A: The answer depends upon many factors including your health, your mental
attitude, the support of your family and friends, and the opportunity to practice.
Q: Who gives me speech therapy?
A: The names and locations of qualified speech instructors can be obtained from
your surgeon. Many insurance plans and state programs provide coverage for
these services.
Q: What is an electrolarynx?
A: It is a mechanical substitute for the vocal cords that produces a vibration for
speech sounds. Many devices are held against the side of the neck. As it
vibrates, the electrolarynx introduces sound into the throat and hence, to the
mouth. Another device conducts sound directly into the mouth. With both types,
the sound is articulated by the throat, lips, teeth and tongue to produce speech.
Q: What is esophageal speech?
A: Esophageal speech is produced when air is expelled from the upper esophagus,
almost as in belching. The vibrating esophageal opening produces the sound,
which is resonated and articulated, as in normal speech, by the use of the throat, lips, teeth, tongue and soft palate.
Q: What is TEP speech?
A: TEP speech is created when a small plastic prosthesis is inserted into a surgically created passage through the common wall between the trachea and the esophagus. The prosthesis is a son-way valve which, when occluded, directs air from the lungs into the esophagus. The escape of this air is then articulated in a manner similar to esophageal speech.
Q: Safeguards to observe:
A: A.Always have your stoma covered with a soft, porous, non-shedding cover.
If you are exposed to excessive dust, pollution or other irritants, use a
double protective covering, with the outer one dampened to create
moisture in your airway.
B.When you cough, cover both your mouth and neck area.
C.In cold weather, use a warm scarf loosely wrapped around the neck. This will warm the cold winter air, but will not impede breathing.
D.Protect your stoma from water at all times. During your bath or shower, use a shower shield made of hard or soft plastic or a rubber bib.
Hairsprays, colognes, aftershaves, and other cosmetics may be irritation to
your stoma, so exercise caution both at home and at the beauty parlor and
barbershop.
E. Be extremely careful at the ocean, lake or poolside. Remember your stoma is connected directly to your lungs and will fill quickly with water if you submerge yourself underwater.
F. Have no fears about sleeping. If a blanket or pillow were to somehow cover your stoma area, instinct will cause you to wake up or roll over.
G.Avoid dry heat indoors by using a humidifier. This is very important in your sleeping area.
H.Don't rush yourself. Allow plenty of time to get where you want to go.
The more relaxed you are, the better you will feel and the better you will
be able to speak.
I.Wear a medical identification bracelet stating that you are a "neck breather".
J.Follow all instructions from your surgeon. The regular check-up is for your safety and continued recovery - don't miss one of them!
Q: What is a laryngectomee organization?
A: It is a group of people who have had a laryngectomy. The laryngectomees, their
families and friends meet regularly to offer encouragement to each other, to share information on resources and to socialize. Speech instruction is often available.
This support is especially valuable to the new laryngectomee. These organizations are usually referred to a Lost Chord Clubs or Nu Voice Clubs
