(see also provoxweb)
The department of Otolaryngology-Head&Neck Surgery of the Netherlands Cancer Institute has a long history in clinical research on the three main rehabilitation issues after total laryngectomy: voice, pulmonary function, and olfaction. This research is led by dr. F. Hlilgers and A. Ackerstaff. Over the past years, the subjects in this field that have been addressed comprise of:
Vocal rehabilitation:
- improvements in prosthetic voice rehabilitation by the development of two generations of voice prostheses, and recently the development of a novel multi-magnet automatic speaking valve, enabling hands-free speech;
- long-term clinical assessment of the results of prosthetic voice rehabilitation, both in mono-center and multi-center trials;
- analyses of the anatomical and functional characteristics of the neoglottis, relevant for voice quality;
- development of a multidimensional assessment protocol for evaluation of voice quality in tracheoesophageal speech.
Pulmonary rehabilitation:
- assessment of the physical and psychosocial problems after total laryngectomy;
- establishing the magnitude and severity of the patho-physiological changes of the respiratory system, caused by the disconnection of the upper and lower airways, which inevitably result in significant pulmonary problems;
- development of specialized heat- and moisture exchangers (HME's) for pulmonary rehabilitation; the regular use of HME's results in (subjective and objective) improvement of pulmonary function, better voice quality, and an improved quality of life of laryngectomized patients.
Olfactory rehabilitation:
- assessment of the deterioration of olfaction after total laryngectomy;
- development of a the ‘Nasal Airflow Inducing Maneuver’ for olfactory rehabilitation. With this technique, assessed in an intervention study, it is possible to restore olfaction in laryngectomized patients.
Currently, comprehensive protocols for rehabilitation after total laryngectomy by speech therapists are addressing all three issues mentioned.
