Speech rehabilitation after total laryngectomy.

The outcome of speech therapy for 65 laryngectomees at Kitasato University Hospital is reported and what needs to be done in order to establish a better system for laryngectomee rehabilitation in Japan is discussed. Of the 65 patients, 53 were trained for both esophageal and electrolarynx speech, 8 for electrolarynx speech only and 4 for esophageal speech only. Of the 57 patients who were trained for esophageal speech, 38 continued the training for a period of > 6 months. Of these 38, 36 (94.7%) could produce one-syllable sounds at the first session. For the production of 5-6 syllables, a median of 6 sessions was necessary for the total laryngectomee group and 10 sessions were necessary for the pharyngo-laryngo-esophagectomee group but the difference was not significant. The study showed that for the production of a single esophageal sound the training period in our hospital was much shorter than that reported in other Japanese studies. Of the 65 patients, 27 (41.5%) acquired practical esophageal speech and 59 (90.8%) acquired either esophageal or electrolarynx speech. Six (9.2%) could not acquire any alaryngeal speech and this percentage was lower than that reported in other studies from Japan (12.5-33%) and from other countries (8.5-40%).