Effect of Aging on Tracheoesophageal Speech Rehabilitation

Abstract

Objective: 1) To determine whether tracheoesophageal puncture usage changes as a function of age. 2) To determine whether age is associated with voice deteroriation, need for repuncture, or dependence in stomal care. Method: Retrospective chart review on individuals following total laryngectomy and tracheoesophageal puncture (TEP) and minimum 1-year follow-up data after prosthesis placement. Data reviewed included demographic variables and medical/surgical factors related to laryngectomy. Outcome measures of voice deterioration, TEP use, repuncture, and change in dependent prosthesis management were compared with age. Results: Sixty-nine individuals were identified that met criteria; 58 men and 11 women. Mean age was 65 years (range, 43-88 years). Nine individuals, mean age of 70.0 years, did not use their prosthesis for speech purposes; 2 chose never to use it and the remainder became unable to speak due to further medical issues. Deterioration in speech was further noted in five individuals, mean age of 79.4 years. Seven individuals, mean age of 58.6 years, required a re-puncture due to extrusion. Six individuals with a mean age of 76.3 years became dependent over time for daily stoma management. Conclusion: Age was significantly associated with deterioration in alaryngeal voice quality and need for dependence in stoma care for older individuals while repunctures were associated with a younger age. These results support careful selection criteria and counseling when considering a tracheoesophageal puncture in an older aged individual.