Comprehensive esophageal speech training for laryngectomees: Substantial benefits
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Abstract
Background: Head and neck cancer is one of the major cancer burdens in Thailand and Southeast Asia. Most patients with laryngeal cancer present at an advanced stage and require laryngectomy. Esophageal speech (ES) is an option for effective communication.
Objectives: To determine the effectiveness of comprehensive esophageal speech under the “Training for The Trainer” project.
Materials and methods: Ninety-four laryngectomees (patients with laryngeal cancer undergoing total laryngectomy) received esophageal speech training by speech and language pathologists (SLPs) and the trainers or laryngectomee volunteers. ES was instructed on a monthly for 4 years. Project “Camp of Hope and Spirit for Layngectomees”, which provides support to improve quality of life by integration of music, art, nutrition, and dharma with healthy activities, was also conducted.
Results: Thirty-six patients who attended ES classes for 6 sessions (1 session compose of 5 periods) had an average improvement in their level of ES of 3.27 levels and 19 laryngectomees who attended ES classes for 12 sessions had average improvement of their level of ES of 4.74 levels. The success rate for ES at level 1 (belch 1-5 times in 10 attempts) was 72% and level 5 (2-syllable words/phases for 1-5 times in 10 attempts) was 34 of 94 (36%) within 12 sessions. Srinagarind ES score was found improved significantly between the 1st and 6th visit (MD=4, 95%CI=2-4); the 1st and 12th visit (MD=6 , 95%CI=2.5-7). Twenty-eight of a total 34 patients (82.35 %), who could use ES at level 5, did not require an electrolarynx. Therefore, a saving of the cost of electrolarynx purchase of 896,000 Baht (32,000 Baht/case). Satisfactions with ES training and “Camp of Hope and Spirit for Laryngectomees” were scored as good to excellent.
Conclusion: The success rate for ES at level 1 was 72% and level 5 was 36% within 12 sessions. A saving of the cost of electrolarynx purchase of 896,000 Baht (32,000 Baht/case) within 4 years. Satisfactions with ES training and “Camp of Hope and Spirit for Laryngectomees” were scored as good to excellent.
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