Effective communication using a speech aid for a postlaryngectomy patient undergoing regional anesthesia: a case report.
A 73-year-old postlaryngectomy male with a tracheostomy was admitted for bladder biopsy and right retrograde pyelogram. At the preoperative visit, the patient was able to communicate effectively only after the suggestion was made to use his speech aid. The patient was asked to bring his Servox Inton electrolarynx to the operating room. The patient received a spinal anesthetic. Adequate communication during the 150-minute procedure was maintained using his speech aid. Postlaryngectomy voicelessness is a cause of psychological trauma in the postlaryngectomy patient. Different techniques have been proposed for producing sounds. An artificial larynx can be used for the postlaryngectomy patient while, or instead of, learning other types of speech. To prevent the possibility of electrical shock while using a metal encased electrolarynx in conjunction with an electrosurgical unit, we recommend removing the metal housing. When intubating a patient with a speech prosthesis in a surgically created tracheoesophageal puncture, we suggest removing the prosthesis and stenting the tracheoesophageal puncture with a catheter. This will prevent both disloding of the speech prosthesis and closure of the fistula. It is important for the anesthetist to become familiar with speech aids in order to establish effective communication with postlaryngectomy patients.
Burnstein
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D000368:Aged; D000765:Anesthesia, Conduction; D003142:Communication; D006801:Humans; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male