title: [An influence of some factors on the logopedic rehabilitation of patients after total laryngectomy].
abstract: BACKGROUND
  The operation of total laryngectomy deprives patients of the ability of voiced communication, causes isolation and loneliness. The loss of voice and speech leads to a predominant cripplehood, disturbs verbal communication in the social and family circle. The best ways of voiced communication of the patients after laryngectomy are an esophageal speech and the speech using voice prosthesis.
  
  
  OBJECTIVE
  The aim of the study is to estimate the voice and speech rehabilitation of the patients after total laryngectomy.
  
  
  METHODS
  The study comprised 30 patients who in the years 2007-2009 underwent an operation of laryngectomy at the Department of the Surgery of the Head and Neck and the Laryngological Oncology in the Greater Poland Cancer Center in Poznań. In this group 9 patients used voiced speech after grafting the voice prosthesis, 15 patients (12 men and 3 women) underwent a classical rehabilitation of the esophageal speech, 6 patients (4 men and 2 women) used an electronic voice prothesis. The most important factors which influenced on mastering an esophageal speech were: pressure inside the esophagus, appearing a reverberation, time of training at home, length of time of logopedic rehabilitation, age and education.
  
  
  RESULTS
  Necessary time to master a speech in the group of 9 patients with voice prothesis was 4-5 days. Length of time of the classical speech rehabilitation lasted from 3 to 8 months. 3 persons (20%) mastered a very good degree of esophageal speech, 7 patients a good degree (46.67%) and 2 patients (13.33%) - a sufficient degree of esophageal speech despite of low pressure inside the esophagus and appearing a reverberation quickly. 3 patients (20%) used an oral and guttural pseudo-whisper, a voiced reverberation was not obtained during the whole time of logopedic rehabilitation.
  
  
  CONCLUSIONS
  The surgical voice rehabilitation, in spite of the possibility of complications, enjoys a great popularity among patients. The classical rehabilitation of the esophageal speech was more difficult for the tasted group of patients but mastering a speech to a very good and good degree lets communicate naturally.
authors.affiliation: Oddział Laryngologiczny, Szpital Wojewodzki w Zielonej Górze. sokalwr@poczta.onet.pl
authors.forename: Wioletta
authors.initials: W
authors.lastname: Sokal
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kordylewska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Golusiński
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D011044:Poland; D012189:Retrospective Studies; D013065:Speech Intelligibility; D013068:Speech Production Measurement; D013070:Speech Therapy / Q000379:methods*; D013072:Speech, Esophageal / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014833:Voice Quality; D014834:Voice Training