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Stimmrehabilitation nach totaler Laryngektomie

Ein chronologischer, medizinhistorischer Überblick

Voice rehabilitation after total laryngectomy

A chronological review of medical history

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Abstract

Hintergrund

Der Verlust der Stimme ist für den Patienten die einschneidendste Folge der Kehlkopfentfernung. Deshalb war schon mit der Idee der totalen Laryngektomie die Möglichkeit der Stimmrehabilitation fest verbunden. Die Vielzahl verschiedener technischer und chirurgischer Ansätze beleuchtet die Problematik, die mit Rehabilitation der Stimm- und Schluckfunktion nach Kehlkopfentfernung verbunden ist.

Methoden

Die aktuelle medizinische Literatur sowie medizinhistorische Quellen wurden mittels Internetsuchmaschinen und Bibliotheken durchsucht und die richtungweisenden Publikationen identifiziert und zusammengefasst.

Ergebnisse

Die Methoden zur Stimmrehabilitation können in 4 Gruppen eingeteilt werden: Apparative externe Hilfsmittel, prothetische und rein chirurgische Stimmfisteln zwischen Trachea und Ösophagus und die Ruktusstimme. In den letzten 30 Jahren haben sich Stimmfisteln/Stimmprothesen durchgesetzt, einige Patienten verwenden jedoch weiterhin die Ruktusstimme oder äußere Hilfsmittel für den Notfall, wenn die Prothese einmal nicht funktioniert.

Abstract

Background

Loss of voice is the consequence of laryngectomy most disturbing for the patient. As such, the notion of performing a laryngectomy has always been directly linked to the possibility of voice rehabilitation. The multitude of different technical and surgical approaches pays testimony to the problems associated with rehabilitation of speech and swallowing after laryngectomy.

Methods

Scientific online search engines and library facilities were used to search for recent publications and historical medical documents. Important works were identified and summarized.

Results

Four different categories of voice rehabilitation can be identified: external (electrical) devices, esophageal speech, and tracheoesophageal shunts either with or without fistula valves/voice prosthesis. During the past three decades, fistula valves/voice prostheses have become the state of the art, with some patients still using esophageal speech or external devices as a back-up method in case of prosthesis failure.

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    K. J. Lorenz

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Lorenz, K.J. Stimmrehabilitation nach totaler Laryngektomie. HNO 63, 663–680 (2015). https://doi.org/10.1007/s00106-015-0043-4

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