Systematic Review of The Outcome of Different Modalities of Voice Rehabilitation Following Total Laryngectomy

Abstract

Background: Speech impairment occurs in 34-70% of head and neck oncologic patients. Management of this impairment is through surgical and nonsurgical methods. Progress in voice rehabilitation following total laryngectomy has over the last 30 years, made an enormous difference in the whole concept of the management of laryngeal cancers. Objective: To explore the outcome of different options of voice rehabilitation after total laryngectomy and the advantages and disadvantages of each method in order to improve the quality of life of laryngectomized patients and the suggestion of future directions for research. Patients and Methods: The Aim of this work is to provide cumulative data about the efficacy and safety of the outcome of different modalities of voice rehabilitation following total laryngectomy. This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. Results: Voice rehabilitation is one of the most important determinants of the quality of life after total laryngectomy. Recent advances in prosthetic voice devices have made such devices the gold standard for voice rehabilitation. They are thus preferred and used more often than old methods (esophageal speech and artificial larynx). Conclusion: Although, no single method is considered to be the best for every patient, the tracheoesophageal puncture has become the most preferred method in the past decade. But it is not always possible in all patients, the results of this study indicate that ES, when achievable, is a viable option that should be considered by surgeons when making intervention decisions on patients, and should be revived when indicated. But we need much more studies.