Canadian Journal of Speech-Language Pathology and Audiology

Postlaryngectomy Speech Rehabilitation: Contemporary Considerations in Clinical Care

Author(s) Philip Doyle, PhD
Volume 23
Number 3
Year 1999
Page(s) 109-116
Language English
Keywords laryngectomy
Abstract The removal of one’s larynx due to cancer results in changes that cross anatomical, physiological, and psychological boundaries. Oncologic safety is primary for those undergoing total laryngectomy; however, the immediate and complete loss of verbal communication results in significant challenges to one’s well-being. In some instances, these changes may threaten the success of long-term rehabilitation outcomes. The World Health Organization (WHO; 1980) has identified three fundamental areas and the impact of each on the individual’s rehabilitation. These areas included: (a) impairment, (b) disability, and (c) handicap. Recently, these areas have been elaborated to address structure and function, activities, and participation, respectively. As such, the WHO recommends that any comprehensive rehabilitation plan include attention to the performance of, or barriers to, activities as well as social attitudes and potential social penalty due to disease and its treatment. Thus, if postlaryngectomy rehabilitation is to be successful, professionals working with those who undergo laryngectomy must carefully consider and seek to comprehensively address the effects of postlaryngectomy changes in each of these areas. This article addresses the importance of these considerations in contemporary clinical practice.

L’ablation du larynx due à un cancer entraîne des changements qui vont au-delà des frontières anatomiques, physiologiques ou psychologiques. Quoique la sécurité oncologique soit prioritaire chez les personnes subissant une laryngectomie totale, la perte immédiate et complète de la communication verbale présente d’importants défis au bien-être de la personne. En certains cas, ces changements peuvent compromettre le succès des résultats à long terme de la réadaptation. L’Organisation mondiale de la santé (OMS; 1980) a désigné trois aspects fondamentaux et leur incidence individuelle sur la réadaptation de la personne. Ce sont (a) déficience, (b) incapacité, et (c) handicap. L’OMS recommande que tout plan complet de réadaptation tienne compte de la pénalité sociale découlant de la maladie et de son traitement. Ainsi, pour que la réadaptation post-laryngectomie soit une réussite, les professionnels œuvrant auprès des personnes subissant une laryngectomie doivent chercher à se pencher sur l’ensemble des effets des changements découlant d’une laryngectomie dans chacun de ces aspects. Ce mémoire examine l’importance de ces considérations dans la pratique clinique contemporaine.
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