Functional Rehabilitation after Total Laryngectomy - Practical Considerations - Review

Background Total laryngectomy, through its radical and mutilating nature, irreversibly affects the quality of life of the patient by generating a major handicap-aphonia. Methods of vocal rehabilitation were imagined even from the first total laryngectomy, which was performed by Theodor Billroth, and now modern medicine has a varied technical and surgical armamentarium through which voice can be "restored" to a laryngectomee. Materials and method An analitic review of the published studies was performed for the various methods available for functional rehabilitation after total laryngectomy, with a classification being made after the results were obtained. The parameters by which the analysis was made were: voice quality (evaluated objectively and subjectively), quality of life of the laryngectomized patient and cost of the method (hospitalisation related costs, device price, maintenance cost). Results and conclusion Tracheo-oesophageal fistulization with vocal prosthesis implantation currently is the method of choice for functional rehabilitation after total laryngectomy, representing an optimal compromise between the voice quality, ease of utilisation and costs. This method is not however without faults, so the future may bring with it an improvement of these devices as well as new methods being introduced in current practice.