title: Speech rehabilitation after total laryngectomy: long-term results with indwelling voice prosthesis Blom-Singer.
abstract: To evaluate long-term use of indwelling Blom-Singer voice prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). We studied the influence of time of performance of tracheo-esophageal puncture (TEP), use of radiotherapy (XRT), patients' age and length of follow-up, on the rate of success of use of VP.
  
  
  METHODS
  Clinical prospective.
  
  
  METHODS
  Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. Both otolaryngologist and speech pathologist evaluated all patients for the vocal functional issues during the follow-up. The relative data on time of placement of VP, time of use of PF, use of XRT, age, length of follow-up and interval of duration of each VP were recorded during the follow-up.
  
  
  RESULTS
  There was 87% of patients with primary TEP and 13% with secondary. The follow-up varied from 12 to 87 months, with average of 38 months for primary and 51 months for secondary TEP. There were 59% of patients submitted to XRT. The general rate of success was of 94%. In primary TEP it was of 97% and in the secondary, it was 78% (p=0.07) and after two years, the success rate was of 96% in primary TEP and 75% in secondary TEP (p=0.07). The use of XRT and patient age did not influence the success of use of VP among primary and secondary TEP, independently of length of follow-up.
  
  
  CONCLUSIONS
  Tendency to greater success rate in voice rehabilitation after TL with primary TEP was observed. Postoperative XRT and age did not influence success rate.
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas. carloschone@uol.com.br
authors.forename: Carlos Takahiro
authors.initials: CT
authors.lastname: Chone
authors.forename: Ana L
authors.initials: AL
authors.lastname: Spina
authors.forename: Agricio N
authors.initials: AN
authors.lastname: Crespo
authors.forename: Flavio M
authors.initials: FM
authors.lastname: Gripp
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial / Q000592:standards*; D008875:Middle Aged; D011446:Prospective Studies; D013070:Speech Therapy / Q000379:methods / Q000592:standards*; D013071:Speech, Alaryngeal; D013997:Time Factors; D016896:Treatment Outcome