title: Speech rehabilitation during the first year after total laryngectomy.
abstract: BACKGROUND
  Gaining a new voice is one of the major aims after total laryngectomy. The objective of this study was to describe the process and results of speech rehabilitation during the first year after surgery.
  
  
  METHODS
  Speech intelligibility was measured 6 months (n = 273) and 1 year (n = 225) after total laryngectomy.
  
  
  RESULTS
  Objective (23.4 to 47.5 points, p < .0001) and subjective (51.6 to 64.7 points, p < .0001) speech intelligibility improved between 6 months and 1 year after total laryngectomy. Patients who used tracheoesophageal puncture (TEP) had the best results in speech intelligibility 6 months and 1 year after total laryngectomy. In all, 12% of the patients who used TEP initially no longer used it 1 year later. Patients who had received rehabilitation had better objective speech intelligibility than those who did not.
  
  
  CONCLUSIONS
  Speech improves considerably between 6 months and 1 year after total laryngectomy. Nonattendance of rehabilitation is associated with a worse functional outcome in speech rehabilitation.
authors.affiliation: University of Leipzig, Department of Medical Psychology and Medical Sociology, Leipzig, Germany; University of Mainz, Division of Epidemiology and Health Services Research, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.forename: Dorit
authors.initials: D
authors.lastname: Wollbrück
authors.forename: Andreas
authors.initials: A
authors.lastname: Dietz
authors.forename: Juliane
authors.initials: J
authors.lastname: Schock
authors.forename: Friedemann
authors.initials: F
authors.lastname: Pabst
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Vogel
authors.forename: Jens
authors.initials: J
authors.lastname: Oeken
authors.forename: Annett
authors.initials: A
authors.lastname: Sandner
authors.forename: Sven
authors.initials: S
authors.lastname: Koscielny
authors.forename: Karl
authors.initials: K
authors.lastname: Hormes
authors.forename: Kerstin
authors.initials: K
authors.lastname: Breitenstein
authors.forename: Heike
authors.initials: H
authors.lastname: Richter
authors.forename: Andreas
authors.initials: A
authors.lastname: Deckelmann
authors.forename: Sarah
authors.initials: S
authors.lastname: Cook
authors.forename: Michael
authors.initials: M
authors.lastname: Fuchs
authors.forename: Sylvia
authors.initials: S
authors.lastname: Meuret
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000534:rehabilitation* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods / Q000534:rehabilitation*; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D013065:Speech Intelligibility; D013068:Speech Production Measurement; D013070:Speech Therapy / Q000379:methods; D013072:Speech, Esophageal / Q000379:methods*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D014833:Voice Quality