Krzysztof Izdebski and Rob Mickel (USA)

Voice restoration in total esophageal stenosis post total laryngectomy and radiation therapy. A case for Tokyo larynx

When surgery and radiation treatment compromise the upper esophagus in a post- totally laryngectomized patient, such a patient is deprived oral nutrition intake and can not receive tracheoesophageal puncture to restore phonation with an indwelling voice prosthesis. Injection speech cannot be acquired as well A hard and woody neck surface precludes the use of a surface electrolarynx. One option is to use intraoral Cooper-Rand style electrolarynx, but typically this device produces speech of extremely low intelligibility. To provide excellent speech based on ventilatory and speech coded respiratory timing, we used “Tokyo-Larynx”, an ingenious device which uses pulmonary air to drive a rubberband-based buzz generator. The resultant sound is directed in the retro-grade fashion, yet directly into the oral cavity. We show how this simple device produced nearly normal sounding speech in a case with severe post radiation esophageal stenosis.

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