title: [Voice rehabilitation after laryngectomy with tracheoesophageal prosthesis. Analysis with special reference to psychosocial factors].
abstract: The first 2 years' experiences with Provox prostheses at the ENT Clinic of the University of Berne are discussed. Thirty-three prostheses were inserted after primary tracheoesophageal puncture and 5 after secondary puncture. Voice success was measured with the scale of Robillard Shultz and Harrison, which encompasses not only assessment of voice quality but also frequency of use and a patient's independence in prosthesis care. After primary puncture the percentage of "functional" speakers increased progressively from 26% after 2 months to 56% after 1 year. After secondary puncture only 2 of 5 patients became functional speakers after 6 months. Because only a few of the previously laryngectomized patients who were informed about the possibility of a secondary puncture wished to receive a prosthesis, the reasons for their reservation were analyzed. Uneasiness about an additional operation and fear of complications were the most frequent motives. Further psychosocial aspects--including the unwillingness of some patients to use their fully functioning prosthesis--are discussed.
authors.affiliation: Universitätsklinik für HNO, Hals-, Kiefer- und Gesichtschirurgie Bern.
authors.forename: J
authors.initials: J
authors.lastname: Kollbrunner
authors.forename: M M
authors.initials: MM
authors.lastname: Gadient
authors.forename: S
authors.initials: S
authors.lastname: Aebischer
authors.forename: P
authors.initials: P
authors.lastname: Döbeli
authors.forename: P
authors.initials: P
authors.lastname: Zbären
mesh_terms: D004947:Esophagus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007825:Laryngectomy / Q000523:psychology / Q000534:rehabilitation*; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D011474:Prosthesis Design; D011677:Punctures; D011788:Quality of Life; D012648:Self Care / Q000523:psychology; D014132:Trachea; D014705:Verbal Behavior; D014833:Voice Quality
vernacular_title: Stimmrehabilitation nach Laryngektomie mit tracheoösophagealer Prothese. Analyse mit besonderer Berücksichtigung psychosozialer Faktoren.