Voice problems following limited surgical excision.

The published literature contains relatively few references to vocal rehabilitation for persons with partial laryngectomy. Articles on various types of surgery indicate that many individuals develop satisfactory voice following limited surgery, particularly supraglottic procedures. An informal questionnaire completed by 10 larngologists who had had substantial experience with sub-total laryngectomy revealed that an average of 25 percent of their patients with laryngeal cancer receive partial laryngectomy. Lesions limited to the epiglottis, supraglottic areas or one vocal cord are regularly treated by limited excision. Half of the questionnaires indicated that partial laryngectomy can be used for bilateral vocal cord lesions under certain circumstances. The questionnaire confirmed the published reports that most of the subsequent voices were satisfactory or good and many recover without special vocal retraining. Non reported employment of partial laryngectomy for sub-glottal cancer. Hemilaryngectomy and cordectomy frequently resulted in some impairment of voice. Speech therapy is often recommended when possible. Therapy applicable to voice following partial laryngectomy combines five emphases: 1. strengthening glottic closure and loudness of the voice; 2. improving the efficiency of breath expenditure; 3. increasing the articulatory skill and intelligibility of speech; 4. recognizing and compensating for hearing loss; and 5. aiding the patient to reduce detrimental environmental influences and to adjust to his environmental requirements.