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Invited Commentary
September 29, 2016

Prosthetic Voice Rehabilitation Following LaryngectomyIt’s the Archer Not the Arrow

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles
JAMA Otolaryngol Head Neck Surg. Published online September 29, 2016. doi:10.1001/jamaoto.2016.2881

Total laryngectomy (TL) as an operation has evolved since it was first performed by Billroth in 1873, and has declined in use as the primary treatment for advanced laryngeal cancer. This decline in use has been arguably associated with a decline in survival rates.1 Less controversial is the critical requirement to provide alaryngeal patients with acceptable forms of voice restoration, which include electrolarynx, esophageal speech, and indwelling tracheoesophageal prostheses (TEP).2 Of these, the use of TEP has been shown to significantly improve patient quality of life, self-esteem, and sexual function with concomitant decrease in symptoms of depression and anxiety.3 Objective assessments of voice restoration outcomes, including TEP device life, are necessary to properly counsel patients and engage in shared decision making about voice restoration after laryngectomy.

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