User:Khaen23/sandbox

Along with the help of a few classmates, I will be attempting to add to the laryngectomy wikipedia page. The contribution that I was planning on including was information on esophageal and/or tracheoesophageal speech post-laryngectomy. As I continue my research, I will include relevant articles in a bibliography below.

Relevant journal articles (reviews or meta-analyses):

Review of voice rehabilitation methods post-laryngectomy

The use of botulinum toxin to improve voice post-laryngectomy

Guidelines post-head and neck cancer

Laryngectomy and radiotherapy

Tracheoesophageal prosthesis

Voice rehabilitation

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Potentially relevant books:

Medical procedure overviews

Laryngectomie surgery

Voice rehabilitation using prostheses

Cancer réhabilitation (head/neck)

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Although it is not a journal article or a book, this website from ASHA provides key information:

Signs, symptoms and care

Suggested additions for the tracheoesophageal speech section of the laryngectomy wikipedia page:

Expansions on sections already present:

In total laryngectomy, the larynx (including the vocal folds, hyoid bone, epiglottis, thyroid and cricoid cartilage and a few tracheal cartilage rings) are removed.

Tracheoesophageal punctures (TEP) with voice prostheses allows individuals post-laryngectomy to have a voice to speak, while also avoiding aspiration of saliva, food or other liquids.

Tracheoesophageal speech is considered more natural sounding than esophageal speech, but voice quality differs from person to person.

Methods of diagnosis of laryngeal cancer:

Certain laryngeal cancer locations (e.g. at the level of the glottis) can cause an individual's voice to sound hoarse.

To determine the severity/spread of the laryngeal cancer and the level of vocal fold function, indirect laryngoscopies using mirrors, endoscopies (rigid or flexible) and/or stroboscopies may be performed. Other methods of visualizations using CT scans, MRIs and PET scans and investigations of the cancer through biopsies can also be completed. Examinations are used to determine the tumor classification (TNM classification) and the stage (1-4) of the tumor. The increasing classifications from T1 to T4 indicates the spread/size of the tumor and provides information on which surgical intervention is recommended, where T1-T3 (smaller tumors) may require partial laryngectomies and T4 (larger tumors) may require complete laryngectomies.

Use of Botulinum toxin:

For individuals using tracheoesophageal or esophageal speech, botulinum toxin may be injected to improve voice quality when spasms or increased tone (hypertonicity) is present at the level of the pharyngoesophageal segment muscles. The amount of botulinum toxin administered unilaterally into two or three sites along the pharyngoesophageal segment varies from 15 to 100 units per injection. Positive voice improvements are possible after a single injection, however outcomes are variable. Dosages may need to be re-administered (individual-dependent) after a number of months, where effective results are expected to last for about 6-9months.