Laryngectomized users of tracheoesophageal prosthesis: principles and methods of speech-language pathology practice

ABSTRACT

Objective: To analyze the current principles and methods in speech-language pathology (SLP) therapy of total laryngectomized patients who are users of tracheoesophageal prosthesis from the point of view of speech-language pathologists, head and neck surgeons and patients. Methods: The participants of the research were three speech-language pathologists (GP), three head and neck medical surgeons (GS) and three tracheoesophageal prosthesis users (GU). The speech-language pathologists responded to an interview containing one question of open-ended character on their experience in the rehabilitation of these patients. Starting from the reading of the collected material, a questionnaire was elaborated for GS on their expectations as to the SLP therapeutic process and another for GU about specific techniques, expectations and recollections of the SLP therapy process. After the reading of the material, associative idea maps were elaborated. In that way, analysis was carried out individually for each group. In a second round, responses of the interviewees of the three groups were compared among themselves with base in elaborated categories. Results: The performance in the preoperative period consists of orientations concerning the surgery and their implications and on the available alternative methods of communication. After the surgery, SLP therapy consists predominantly of specific techniques for occlusion of the stoma, coordination between expiration and phonation, speech fluency, maximum phonatory time and vocal variations of height and intensity. Conclusion: It is observed that the function of the speech-language pathologist is to propitiate the patient a mastery of the prosthesis through expression and autonomy in caring for the same. In that way, the improvement of the quality of life, by reintegration into society, becomes the main performance objective with laryngectomized patients.