title: International practice of laryngectomy rehabilitation interventions: a perspective from South Africa.
abstract: OBJECTIVE
  This review reflects on the experience of speech rehabilitation of laryngectomees at the Groote Schuur Hospital in Cape Town and expands on ways of dealing with the challenges that practising in a developing world setting presents.
  
  
  RESULTS
  Postlaryngectomy speech rehabilitation is unavailable in most African countries because of a profound shortage of speech and language therapists, otolaryngologists, and trained head and neck surgeons, as well as fiscal limitations. This article presents our recent tracheoesophageal speech results; discusses the employment of early postlaryngectomy feeding, selection criteria for patients for tracheoesophageal speech, the choice of voice prosthesis, follow-up care of patients coming from afar; and presents the results of a comparative study of the efficacy of different methods of airway humidification.
  
  
  CONCLUSIONS
  Our data and experience illustrate that excellent postlaryngectomy speech results can be achieved in a developing world setting by a dedicated team comprising speech and language therapists and otolaryngologists, that early postlaryngectomy feeding is well tolerated, and that a simple cotton cloth stoma cover is as effective as more expensive heat moisture exchange devices.
authors.affiliation: Division of Otolaryngology, University of Cape Town and Speech Therapy, Groote Schuur Hospital, Observatory, Cape Town, South Africa. johannes.fagan@uct.ac.za
authors.forename: Johan J
authors.initials: JJ
authors.lastname: Fagan
authors.forename: Roslyn
authors.initials: R
authors.lastname: Lentin
authors.forename: Gavin
authors.initials: G
authors.lastname: Quail
mesh_terms: D006801:Humans; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial; D013019:South Africa; D013070:Speech Therapy