LARYNGECTOMY FAQ'S

What Makes Speech with a TEP?
(by Glenn E. Peters M.D., Director, Division of Otolaryngology
Head and Neck Surgery, University of Alabama at Birmingham,
Birmingham, Alabama, USA)

My subject today concerns the differences in sound produced by different users of the TEP. You have probably noticed in the Support Group meeting that some folks sound great and others seem to struggle.

So why is that?

Let’s start this discussion with the real way that a larynx helps "talk". To put in the simplest terms, all a larynx does is to make the air coming out of our lungs vibrate. That’s it—just vibrate. Speech does not come from the larynx, a vibrating air column does. What we know as speech occurs when this vibrating air column is made into words by our throats, mouths, tongues, lips, teeth, and so on. A case in point is your Servox, which provides vibration only.

Now that we have this background information, let’s get on to our question. Remember that a TEP replaces the larynx by supplying another source of vibrating air. This time what vibrates is the lining of your throat in the lower part of your neck just above your stoma. The differences in speech quality largely center around the differences in this part of the throat and upper esophagus. These differences include the following:

• What was the primary closure method used to close the throat after the larynx was removed:
  1. vertical
  2. "T" type of closure
• · Was a flap of tissue transferred from another part of the body used in your reconstruction, as in:
  1. jejunum
  2. stomach "pull-up"
  3. chest muscle flap
  4. forearm flap
• · Did you have radiation as a part of your cancer treatment
• · Did you have an infection or a fistula after surgery
• · Did you develop spasms in the muscles of your throat after your surgery
• · Do you have less than effective lung power
• · Was it necessary to remove a part of your tongue with your larynx

As you can see, there is a long list of factors that play a role in the development of speech with a TEP. The bottom line is that each patient should be evaluated on an individual basis for this device. While the TEP is probably the state of the art at this present time it might not be best for every patient. To find out more, ask your doctor.