Supraglottic laryngectomies that try to preserve as much anatomy as possible can be problematic for the patient due to the risk of post-surgical
dysphagia
Total laryngectomees may have trouble with heavy lifting or pushing due to
loss of ability to build up intrathoracic pressure
Which alaryngeal speech method allows the user to maintain normal respiration and phonation patterns for speech?
TEP speech
Which alaryngeal speech method is probably the most difficult to master but the least cumbersome and expensive?
esophageal speech
Someone with poor visual and motor skills & no competent caregiver to help them with the device should probably choose which type of TEP?
indwelling
How can laryngectomees eventually regain some ability to smell?
able to direct some air from the mouth up into the nasal passages
The puncture for a TEP is made
between the trachea and the esophagus
Laryngectomees often have increased mucus at the stoma site because of
no filtering of inhaled air through the stoma
If a total laryngectomee has any dysphagia, it's usually related to
poor UES opening
Which of these TEP's doesn't have to be changed and cleaned daily?
indwelling
Which of these is not a method of forcing air into the UES for esophageal speech?
grunting
What allows a TEP user to achieve completely "hands-free" speech?
external one-way plastic valve over the stoma
The TruTone electrolarynx allows for more natural
intonation
The least natural-sounding alaryngeal speech option is
electrolarynx
Which of these methods of alaryngeal speech is ALWAYS hands-free?
esophageal speech
What provides the sound source for TEP speech?
the vibrating UES
Where does the air for articulating plosives and fricatives come from for esophageal speech?
it's forced back out of the UES
Where does the air for articulating plosives and fricatives come from for electrolarynx speech?
air that's inside the mout
Where does the air for articulation of plosives and fricatives come from for TEP speech?
up from the lungs and directed through the UES
In order for a TEP to work, the laryngectomee has to
occlude the stoma with a finger or a tracheostoma valve
How can a laryngectomee still swallow without the anatomy to produce hyolaryngeal elevation?
bolus pressure from the tongue
One of the more recent and perhaps most frequent cause of laryngeal cancer is now
HPV
Stage IV cancer is always diagnosed if there is
distant metastasis
One of the most debilitating side effects of radiation to the neck is severe dysphagia resulting from
tissue fibrosis
A common treatment for dysphagia in laryngectomees would be
botox or myotomy of the UES
The most natural-sounding (and appearing) alaryngeal speech method would be
TEP speech with a hands-free valve
To determine whether a patient can tolerate and benefit from a TEP, the MD can perform
an insufflation test
Why do you have a patient drink liquid after placing a new TEP?
to check for leaks through and around the TEP
What type of infection tends to cause TEP devices to clog or leak and then need to be replaced?
candida
Why do you remove the little strap from an indwelling prosthesis after it is properly placed in the patient's puncture site?
you dont want them to try to remove it and injure the puncture sight