There are 3 stages of management for laryngectomy: pre-operative, operative, and post-operative management. Each phase has its advantage and objectives. A speech therapist plays crucial roles in the first and last phase. Consulting a speech therapist throughout the very first stage is similarly essential with seeing a therapist throughout the last phase, which is when voice rehabilitation really starts.
A speech therapist also has various roles in each phase, that’s why it is essential for a therapist to understand the 2 phases he plays a role in.
Pre-operative management includes notifying the client of the physiological modifications, and expectations relating to swallowing, voice, and the household as a part of the team. The therapist likewise informs the client on the various speech alternatives he has after the operation.
Throughout this phase, the speech therapist need to start ordering of the hardware or alternative means of communication. The therapist should likewise be open to concerns that the patient may come up with. This is also the time for him to establish relationship with the patient.
The therapist can also use re-assuring assessment with proper laryngectomee volunteers. This is likewise the time where he examines the pre-laryngectomy speech and cognition of the client. The laryngectomee is likewise informed with his diagnosis, where the potential for healing and long-term rehab is talked about.
The benefits of this stage would be the assessment of preoperative speaking abilities such as speaking rate, articulation errors, accent patterns, oral opening degree when speaking, and vocal parameters. Cognition and hearing is likewise evaluated, along with oral-peripheral-mouth strength and sensation. The family can also get emotional assistance in this stage.
Assessment is done by the use of customized barium swallowing or Fiberoptic Endoscopic Examination of Swallowing. The patient’s interaction requirements are likewise assessed where living circumstance, profession, social requirements and hobbies are taken a look at.
During this phase, the therapist is provided a chance to assist minimize the client’s fears, and anxiety. He must also assist the client to accept the loss of voice and swallowing problems. The motivation of the client ought to be increased, so that he can quickly discover the best ways to use alternative speech. Social implications are also resolved. Arrangements for voice rehab are also done throughout the early parts of this phase.
Firs off, the therapist ought to confirm if the patient is already clinically cleared for therapy. Then he ought to review the treatment procedure, re-evaluate the client’s swallowing function then give diet plan recommendations, and produce a treatment strategy.
Issues Encountered Throughout Postoperative Management
After the operation some issues may still take place. With regards to Tracheostomy, the patient and therapist should constantly be watchful of stoma hygiene, cannula health, stoma covers, extreme mucus in the trachea, mucus encrustations in the stoma, and stoma safety and first aid.
There could likewise be issues connected to taste, swallowing, odor and digestion. The patient may find it hard to trap air within the lungs. This can cause troubles in producing internal subglottic pressure, removal of body waste and childbirth.
Problems of social adjustment might likewise be present. The client may find it hard or embarrassing to utilize alaryngeal speech in public. The altered physical appearance of the patient may likewise be a problem. Often, the laryngectomee also has impractical expectations concerning acquisition of alaryngeal speech.