Voice Restoration with the Tracheoesophageal Voice Prosthesis: The Current State of the Art

Abstract

Since its introduction in 1980, the tracheoesophageal (TE) puncture voice restoration method has been shown to be a viable, effective method of speech rehabilitation after laryngectomy. Historically, high success rates have been reported for appropriately selected patients. Since the development of TE voice restoration, however, the laryngectomy population itself has changed dramatically. With the advent of “organ preservation” protocols as a treatment method for advanced laryngeal cancer, many individuals undergo laryngectomy as a secondary procedure after radiation or chemoradiation. As a result, postoperative complications are common, delaying speech and swallowing rehabilitation. Moreover, individuals who undergo complex surgical reconstruction in addition to total laryngectomy may be poorer candidates for a TE puncture. Navigating these issues can pose a challenge for the clinician with regard to determining candidacy, troubleshooting, and managing complications. This chapter will discuss these, as well as other issues, and provide an overview of the current state of the art of TE voice restoration.