Total laryngectomy Exploring voice outcomes and functional issues

A total laryngectomy is an organ-sacrificing surgery which leads to lifelong consequences in anatomy and physiology of the body. During the total laryngectomy procedure, the larynx is removed, which leads to a loss of the natural voice. To rehabilitate speech, three main substitute voice methods are available: tracheoesophageal speech, esophageal speech, and electrolarynx speech. The first part of this PhD-thesis focusses on voice and speech outcomes after total laryngectomy. Speech rehabilitation methods are evaluated in a systematic literature review. Voice outcomes are prospectively evaluated with acoustic, perceptual and quality of life measures. The second part incorporates chapters on functional outcomes, pulmonary issues, and women specific issues following total laryngectomy. A worldwide survey and a training program for pulmonary problems is incorporated. With help of qualitative study methods experiences of female individuals who have undergone total laryngectomy are analyzed. The results of this thesis provide insight into communicative functioning and rehabilitation needs after total laryngectomy.