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Title: Vocal rehabilitation after total laryngectomy
Author: Perry, Alison Rosalind
ISNI:       0000 0003 5116 3689
Awarding Body: De Montfort University
Current Institution: De Montfort University
Date of Award: 1989
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This thesis considers the options for speech rehabilitation for patients who have undergone total laryngectomy - artificial larynges, oesophageal speech and/or surgical speech restoration - and examines the premise that the main reason for failure to develop speech following total laryngectomy is due to anatomical/physiological considerations. A data collection protocol has been devised, in which simultaneous acoustic and aerodynamic measurements are recorded on all laryngectomised subjects during a video fluoroscopic examination. Sixty-eight laryngectomees were examined in total, 13 female and 55 male, over a two-year period at a monthly-held data collection clinic. The results of the study are consistent with the experimental hypothesis. Analysis of acoustic and aerodynamic measurements support the hypothesis of a continuum of tonicity in the reconstructed pharynx, from hypotonicity (where the pharyngo-oesophageal segment is too flaccid to vibrate and produce sound) through tonicity (where good speech results) to hypertonicity and spasm (depending on the degree of excess tone in the reconstructed pharyngooesophageal segment). The objective assessment developed in this study accounts for those subjects who fail to achieve oesophageal speech, rather than simply charting oesophageal speech progress as earlier assessments have done. This assessment helps to determine the path of subsequent clinical management for the laryngectomee who wishes to acquire speech, whether this is oesophageal speech or speech after undergoing a further surgical/ prosthetic procedure. This thesis suggests the development of a proactive and principled model for laryngectomy treatment and indicates future research and directions to pursue in order to improve the prospects for speech rehabilitation in laryngectomised subjects
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Speech rehabilitation