Abstract
The vital role of the speech therapist, in the multi-disciplinary approach to the rehabilitation of patients subjected to ablative surgery for malignant disease of the head and neck region, is reviewed. The role of the surgical techniques of speech rehabilitation of the laryngectomised patient, who has failed to respond to the therapist's instruction in oesophageal speech rehabilitation, is high-lighted. The deliberate pharyngeal fistula created from the pharynx to the skin surface, is connected by a "speech device" to the tracheostomy stoma. The diversion of expired pulmonary air into the pharynx allows for immediate articulation.
Highlights
The vital role of the speech therapist, in the multi-disciplinary approach to the rehabilitation of patients subjected to ablative surgery for malignant disease of the head and neck region, is reviewed
The team of "drastic surgeons" will commit themselves to as wide and extensive surgery as is required to ensure cure, to be followed by a team of "plastic and reconstructive surgeons" who will primarily reconstruct the defect to the limits of physical possibility, thereby fulfilling two of the first important aims of the treatment of such patients: 1. to cure the patient of his disease 2. to restore his cosmetic deformity to as near normal physical appearance as possible. It is at this stage that the vital role of the speech therapist becomes obvious, in order to eventually enable this patient to communicate adequately
These patients experience great difficulty in attempting to articulate due to either the loss of the lip obicularis muscle, or of tongue musculature or loss of mandibular support for the tongue or floor of the mouth musculature. They must of necessity be taught the art of substitute movements in order to articulate the sounds producing intelligible speech. It is the re-education and rehabilitation of speech in the alaryngeal patient that remains the greatest challenge to the speech therapist in such a unit
Summary
The vital role of the speech therapist, in the multi-disciplinary approach to the rehabilitation of patients subjected to ablative surgery for malignant disease of the head and neck region, is reviewed. To restore his cosmetic deformity to as near normal physical appearance as possible It is at this stage that the vital role of the speech therapist becomes obvious, in order to eventually enable this patient to communicate adequately. These patients experience great difficulty in attempting to articulate due to either the loss of the lip obicularis muscle, or of tongue musculature or loss of mandibular support for the tongue or floor of the mouth musculature. It is the re-education and rehabilitation of speech in the alaryngeal patient that remains the greatest challenge to the speech therapist in such a unit
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