Surgical rehabilitation of the voice post total laryngectomy

Introduction: Almost 150 years after the first surgery, total laryngectomy continues to be the surgery of choice for advanced stage laryngeal tumours as well as for the revision of therapeutic failures of radiotherapy that cannot be resolved with other types of partial procedures. Materials and methods: Our study was conducted at the University Hospital of Catania, from 1 January 2010 to 31 December 2020. Voice prosthesis following tracheoesophageal puncture was performed as a primary choice in 13 cases while as a secondary procedure in 29 cases. The use of the oesophageal voice through adequate rehabilitation, on the other hand, was the choice for 15 patients. Results: The VrQoL questionnaire revealed significantly better results in both the Socio-Emotional and Functional domains of the group of patients who underwent voice rehabilitation via voice prosthesis after TEP compared to the group rehabilitated via oesophageal voice. The V-RQoL score showed a worsening of the well-being indices among the patients who had tracheoesophageal fistula related disorders at the control compared to the group rehabilitated with the oesophageal voice. Discussion: Tracheo-oesophageal puncture (TEP) with voice prosthesis (VP) insertion is currently considered the technique of choice for restoring a voice as close as possible to the pre-laryngectomy. It should also be considered that this type of device also offers excellent performance from a psychological point of view, making this type of intervention the best accepted by patients in terms not only of phoniatric but also of improving the quality of life.