Voice-Rehabilitating Surgery at Time of Larynx Removal Benefits Head & Neck Cancer Patients

At the 4th International Conference of Head and Neck Cancer heldin Toronto, Canada, Robert H. Maisel, md, an otolaryngologistat the University of Minnesota Cancer Center, advocated performingtracheoesophageal puncture (TEP) at the time of surgical removalof the voice box due to cancer. While the voice-rehabilitatingsurgical procedure has been part of the cancer operation since1985, it has traditionally been performed several months afterremoval of the larynx.

"The primary TEP (done at time of cancer surgery) shouldbe strongly considered in all laryngectomy patients. Complicationshave been minimal and the potential benefits in rehabilitatingthe patient immediately are very high," says Maisel. Thesebenefits include talking within 2 weeks of the surgery and eliminatingthe need for uncomfortable nasal feeding tubes, as well as obviatingthe need for a second surgery.

Tracheoesophageal puncture enables air to travel from the lungto the mouth and vibrate off the esophagus, allowing the personto make sounds. Approximately 50% of patients undergoing TEP canresume speaking without requiring an artificial voice box or electrolarynx.Although it cannot completely restore voice quality, TEP providesa more natural-sounding voice than does the electrolarynx. Approximately5,000 people a year in the United States undergo laryngectomiesdue to cancer.