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2022, vol. 47, iss. 1, pp. 23-31
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Factors that may affect the success of the esophageal voice and speech education in laryngectomized patients
Faktori koji mogu imati uticaj na uspešnost edukacije ezofagusnog glasa i govora laringektomisanih pacijenata
University of Novi Sad, Faculty of Medicine, Serbia
Abstract
Introduction: The most humane, economically most justified, and according to many authors, also the first method of choice in vocal rehabilitation of totally laryngectomized patients is the use of esophageal voice and speech. While mastering this method, it is necessary to train the patients to form and use the air reservoir in the upper third of esophagus that serves as a voice activator whose airstream causes the vibrations of the pharyngoesophageal segment as the new voice generator. Objective: To investigate the factors that may affect the success of esophageal voice and speech education in clinical practice and emphasize the importance of knowing them in order to further improve this method of rehabilitation. Methods: Comprehensive review of the literature was performed by using the following databases: Google Scholar, SCIndex, PubMed and ResearchGate. The search was based on the following terminology: laryngectomy, esophageal speech, education, factors, success, treatment outcome, and their counterparts in Serbian language. Results: There are numerous factors that may affect the success of esophageal voice and speech education (anatomical-physiological, psychosocial, patient related, treatment and rehabilitation related factors, socio-demographic, physiological and others), among which the motivational status of the patient is of the greatest importance. Conclusion: There are still no clearly defined, generally accepted and comprehensive criteria for assessing the degree of success of mastered esophageal voice and speech, and consequently the lack of defined uniform factors affecting this success, positively or negatively, is present. Of the numerous observed factors, the importance of the patient's motivational status is most often emphasized.
Sažetak
Uvod: Najadekvatnija ,ekonomski najopravdanija, a po mnogim autorima i prva metoda izbora u rehabilitaciji govora totalno laringektomisanih pacijenata jeste korišćenje ezofagusnog glasa i govora. U toku savladavanja ove metode je neophodno osposobiti pacijente da formiraju i koriste rezervoar vazduha u gornjoj trećini jednjaka koji služi kao aktivator glasa, čija će vazdušna struja dovesti do vibracija faringoezofagusnog segmenta, kao novog generatora glasa. Cilj: Prikaz faktora koji mogu imati uticaj na uspešnost edukacije ezofagusnog glasa i govora u kliničkoj praksi kao i ukazivanje na značaj sagledavanja istih tokom vokalne rehabilitacije laringektomisanih pacijenata, u svrhu daljeg usavršavanja ove metode rehabilitacije. Metode: Sveobuhvatan pregled literature izvršen je koristeći sledeće baze podataka: Google Scholar, SCIndex, PubMed i ResearchGate. Termini po kojima je vršena pretraga bili su "laryngectomy", "esophageal speech", "education", "factors", "success", "treatment outcome", te njihovi pandani na srpskom jeziku. Rezultati: Brojni su faktori koji mogu uticati na uspešnost edukacije ezofagusnog glasa i govora (anatomsko fiziološki, psihosocijalni, faktori vezani za pacijenta, lečenje i rehabilitaciju, sociodemografski, hirurški, psihološki, socijalni, fiziološki i drugi) pri čemu motivacioni status pacijenta ima najveći značaj. Zaključak: Još uvek ne postoje jasno definisani, opšteprihvaćeni i sveobuhvatni kriterijumi za vrednovanje stepena uspešnosti ezofagusnog glasa i govora, što za posledicu ima i nepostojanje uniformnih faktora koji utiču na taj stepen uspešnosti, pozitivno ili negativno. Od brojnih posmatranih faktora najveći značaj ima motivacioni status pacijenta.
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