User:Alex BM/sandbox

I hope to talk about voice rehabilitation following a total or partial laryngectomy

Quality of Life
People with a partial laryngectomy are more likely to have a higher quality of life than individuals with a total laryngectomy. Voice quality, swallowing and reflux are affected in both types, with the sense of smell and taste (hyposnia/anosmia and dysgeusia) also being affected in total laryngectomies (a complaint which is given very little attention). People having undergone total laryngectomy have been found to be more prone to depression and anxiety, and often experience a decrease in the quality of their social life and physical health.

People receiving voice rehabilitation report best voice quality and overall quality of life when using a voice prosthesis as compared to esophageal speech or electrolarynx. Furthermore, individuals going through non-surgical therapy report a higher quality of life than those having undergone a total laryngectomy. Lastly, it is much more difficult for those using alaryngeal speech to vary their pitch, which particularly affects the social functioning of those speaking a tonal language.

Smell and Taste Rehabilitation
A total laryngectomy causes the separation of the upper air respiratory tract (pharynx, nose, mouth) and lower air respiratory tract (lungs, lower trachea). Breathing is no longer done through the nose (nasal airflow), which causes a loss/decrease of the sense of smell, leading to a decrease in the sense of taste. The Nasal Airflow Inducing Manoeuvre (NAIM), also known as the "Polite Yawning" manoeuvre, was created in 2000 and is widely accepted and used by speech-language pathologists in the Netherlands, while also becoming more widely used in Europe. This technique consists of increasing the space in the oral cavity while keeping the lips closed, simulating a yawn with a closed mouth by lowering the jaw, tongue and floor of the mouth. This causes a negative pressure in the oral cavity, leading to nasal airflow. The NAIM has been recognized as an effective rehabilitation technique to improve the sense of smell.

Incidence/Prevalence[edit]
In 2017, there were over 13,000 new laryngeal cancer cases in the United States, (3.1 per 100,000). The number of new cases decreases every year at a rate of 2.4%, and this is believed to be related to decreased cigarette smoking in the general population. The number of laryngectomies performed each year in the U.S. has been declining at an even faster rate  thanks to new therapeutic techniques. Only 50,000 to 60,000 laryngectomies have been performed in this country to date.