Subject Index - proedinc.com · speech therapy and,605–606 ... Deﬁnitive obturator,289 Delayed...

Subject Index

773

Acceptance stage of loss, 71, 72Accountability in alaryngeal speech rehabilitation.

See also Speech–language pathologists; spe-cific types of alaryngeal speech;

alaryngeal speech subskills checklist, 671artificial larynx and, 670, 672–673assessment of alaryngeal speech and, 669behavioral goals and, 672esophageal speech (ES) and, 673, 675–679goals of rehabilitation, 668, 670–680lesson planning and, 680, 682–688overview of, 667–668parameters of alaryngeal speech production, 668–

669speech-language pathologist role and, 667termination of therapy, 689, 691therapy report outline, 690therapy session elements and, 686–688tracheoesophageal (TE) speech and, 679–680variable practice and, 685–686

Agealaryngeal speech development problems and,

596–597decision making and, 713laryngeal carcinoma and, 200prevalence of oral cancer and, 600radiation therapy and, 205

AIDS/HIV, 746AL. See Artifical larynx (AL)Alaryngeal speech. See also Accountability in alaryn-

geal speech rehabilitation; specific types ofalaryngeal speech

attributes of, 131–132comparison of types of alaryngeal speech, 61-62,

115distractors and, 63–65extraneous sounds and, 63–64impact of alaryngeal voice on listener, 117–118,

128–129multidimensional structure of alaryngeal speech,

127–128parameters of, 65–70, 668–669pitch and, 68–69prevalence of use of types of, 77–81selection of speech mode, 62–63

speech rate and, 69–70stages of loss and, 70–72subskills checklist, 671successful acquisition of, 78–79vocal loudness and, 63

Alaryngeal speech development problemsage and, 596–597candida, 618–619cognitive-mental status and, 599gastroesophageal reflux, 617–618general health and, 600hypopharyngeal stricture, 614, 616neoglottic tonicity, 616overview of, 595–596, 607–608psychological issues, 595pulmonary health and, 600–602radiation therapy and, 597–599radical surgery and, 603–605self-esteem and, 595sensory changes and, 602–603speech therapy and, 605–606stomal stenosis and irregularity, 616–617

Alcohol, 197, 205, 263, 437, 600, 749“Allgemeine Chirurgische Pathologies und Thera-

pie” (Billroth), 24Altruism, 630American Cancer Society, 373, 633, 634, 660American Laryngological Association, 29, 35American Speech-Language-Hearing Association

(ASHA), 667Andreas Fahl Medizintechnik-Vertribe, 636Anemia, 204Anger stage of loss, 71, 72Anxiety, 12, 641, 646, 649, 711Aphonia. See Delayed postfitting aphonia; Postfitting

aphoniaArticulation

alaryngeal speech, 65–67artifical larynx (AL), 65–67, 559–563, 578dentistry and, 414esophageal speech (ES) and, 65-67, 413–415, 422,

675as goal in rehabilitation, 670hearing loss and, 414injection method for obstruents (IMO), 413

oral articulatory evaluation, 305–306overarticulation, 561–563radical surgery and, 603tracheoesophageal (TE) speech and, 66, 680

Artifical larynx (AL). See also History of Artificiallarynx (AL);Verbal communication

acceptability to listener, 134–135application of term, 19articulation and, 65–67, 559–563, 578average communication profile score and, 86cancer recurrence and, 34candidacy for, 565clinical application of, 548–549communication problems and, 84–85compared with other types of alaryngeal speech,

61–62consistency of voicing, 670current improvement for speech using, 582–588definition of, 549–551dentures and, 565development of, 549–551diagram of, 586evaluation of, 670, 672–673, 674failure with, 79fundamental frequency and, 119–121future of, 587–588general principles of, 35–36goals in use of, 556–564, 672–673hearing loss and, 368illustrations of, 41–42, 44–48implant devices, 579–580, 587intelligibility and, 82, 83, 566, 578, 581, 582, 584intraoral device, 554–555, 578limitations of speech production and, 580–582long-term effects of use of, 106–107loudness and, 67–68, 121–122, 581mouth-type devices, 576–579neck-type devices, 551–554, 574–576, 577, 585nonverbal behaviors and, 564on–off control of, 65, 563–564oral reading rate for, 83overarticulation and, 561–563overview of, 35-36, 79, 547–548, 573pitch and, 581placement and, 63, 557–561, 574preference rate for, 80–81quality of life (QOL) and, 727rehabilitation outcomes and, 566–567selection of, 555signal transmission and, 559speech acceptability and, 550–551speech rate and, 69–70, 561–563statistics on usage of, 61–62success rates of, 548

tissue irritation and, 34training in, 556–564types of, 551–554, 573–580

Artificial voice boxes, 33ASHA. See American Speech-Language-Hearing

Association (ASHA)Aspiration

near-total laryngectomy (NTL) and, 230supracricoid partial laryngectomy with recon-

struction (SCPL) and, 231supraglottic laryngectomy (SGL) procedure and,

227-228swallowing disorders and, 329

Assessmentof artificial larynx, 670, 672–673, 674baseline and, 682–684of esophageal speech (ES), 670, 673, 675, 679goals for rehabilitation and, 670–672oral communication assessment, 299–300, 669oral–motor and communication function assess-

ment, 301–306of patients needing maxillofacial prosthodontics,

307–308performance accuracy and, 687presurgical dental assessment and management,

282, 286of quality of life (QOL), 699–703, 718–722TE speech and, 615, 679–680, 681TEP procedure and, 484–485

Aurex Corporation, 36, 44, 575Autonomy, 707-708, 712

Bargaining stage of loss, 71Behavioral goals, 672Belching, 407Bell Telephone Laboratories, 35, 36, 39, 40, 46Beneficence, 707Biopsy, 26, 28Biopsychosocial model of treatment, 7-9, 724-725,

743-745Bivona, 494, 495, 575Blom–Singer duckbill voice prosthesis, 496, 604Blom–Singer Humidifilter, 497Blom–Singer indwelling voice prosthesis, 483, 494Boston University, 176Botox, 490, 536, 538, 608, 613Bronchodilators, 516

Caffeine, 205Canadian Cancer Society, 633, 634, 651, 660Candida, 455, 467-468, 474, 493, 618–619Candidiasis, 204Carcinoma in situ, 199CAT. See Computer assisted tomography (CAT)

774 � Subject Index

Cellular Pathology, 28Cervical rotation flaps, 241–242Chemotherapy

limitations of, 266overview of, 202–204, 274side effects of, 157, 318vocal tract effects of, 204–205

CHEP. See Cricohyoidoepiglottopexy (CHEP)Children, 365CHP. See Cricohyoidopexy (CHP)Cleft Palate Clinic, 45Clinician’s Guide to Alaryngeal Speech Therapy

(Graham), 420Cognitive-mental status, 599Communication. See also Alaryngeal speech;Verbal

communication;Vocal intelligibility; specifictypes of alaryngeal speech;

communication problems, 84–86communication satisfaction, 98–100counseling and, 299“functional communication”, 96maxillofacial rehabilitation and, 299–306nonverbal behaviors, 416–418, 424, 424–425,

564, 675oral–motor and communication function assess-

ment, 301–306oral reading rate, 82outcome measures, 306–308proficiency of, 81–84social context of, 115speech–language pathologists and, 300, 307telephone communication, 84

Communication Effectiveness Index (Lomas), 307Communication Profile, 85Computer assisted tomography (CAT), 272Computerized tomography (CT), 148, 317Conservation laryngectomy procedures. See also

Nonsurgical treatment of laryngeal carci-noma

near-total laryngectomy (NTL), 230–231overview of, 225supracricoid partial laryngectomy with recon-

struction (SCPL), 231–232supraglottic laryngectomy, 226–228vertical partial laryngectomy (VPL), 228–229voice affect of, 229

Cooper–Rand Artificial larynx (AL), 36, 45, 46Coughing, 199, 595Counseling. See also Group treatment models; Peer

group support; Speech–language patholo-gists

children, 365conversation starters, 375–376educating patients and families and, 362–363

emotional support and, 356–360friends, 365–366grief cycle stages and, 357homecoming preparation, 369–370listening and, 358overview of, 355–356physical disfigurement and, 361postoperative inpatient counseling, 368–369, 373postsurgery outpatient counseling, 370, 374preoperative counseling, 366–368, 372, 458pretreatment counseling, 318–319psychiatric morbidity and, 5spouses, 363–366techniques for, 357–360treatment goals and, 359–360treatment outcomes and, 100–102, 108trust establishment and, 360–362

Cricohyoidoepiglottopexy (CHEP), 231-232Cricohyoidopexy (CHP), 231Cricopharyngeal spasm, 533-535CT. See Computerized tomography (CT)

Death and Dying (Kubler-Ross), 70–71Defect obturation, 275–276, 287–290, 337. See also

Prosthetic managementDefinitive obturator, 289Delayed dysphonia, 491–492. See also DysphoniaDelayed postfitting aphonia, 486Deltopectoral flap (DP), 243–245Denial and isolation, 71–72Dentistry

articulation and, 414dental implants, 282, 285for edentulous and mandibulectomized individ-

ual, 293–294for endetulous individual, 291–292implant-supported prosthesis management, 297–

299for partially edentulous individual, 290–291for partially edentulous mandibulectomized indi-

vidual, 292–293radiation and, 318rehabilitative dentistry, 277–280

Depression, 71, 72, 641, 649, 710, 711, 724, 744Diagnosis, 267–272Disability in America:Toward a National Agenda for Pre-

vention (Pope & Tarlov), 307Distress. See Psychological issuesDrowning, 595Dysphagia, 199, 595, 597, 601–602Dysphonia, 199, 491–492Dysplasia

definition of, 199disease presentation, 173

Subject Index � 775

endoscopic technique and, 178–179management philosophy, 173–176vocal outcome and, 179–182

Dyspnea, 22, 199

Early glottic cancer. See also Glottic cancer; Oralcancer

disease presentation, 173endoscopic technique and, 178–179management philosophy, 173–178vocal outcome and, 179–182

Eating/drinking, 10, 601Educational materials, 709Electronic artificial larynx. See Artifical larynx

(AL)Emotional support, 356-360Endoscopic technique

laryngeal function and, 188–189supraglottic cancer and, 185–188vocal fold atypia and, 178–179vocal outcome and, 179–182

Epithelioma, 29ES. See Esophageal speech (ES)Esophageal insufflation testing, 437-438, 439Esophageal speech (ES). See alsoVerbal communi-

cationacceptability to listener, 134activity score sheets, 419–421advantages of, 381–382air intake and, 386–387, 390–408, 421–425anatomy and physiology of esophageal speech

methods, 390–393articulation and, 65–67, 413–415, 422, 675average communication profile score and, 86cognitive–mental status and, 599communication problems and, 84–85compared with other types of alaryngeal

speech, 61–62consistency of voicing, 670, 673descriptive aspects of, 118disadvantages of, 382durational measures, 122factors for consideration in choosing, 382–383failure in, 383–384, 388–389, 526feedback and, 389, 419–421functional assessment of, 670, 673, 675–679fundamental frequency and, 119–121glottal fricative and, 415hearing loss and, 414, 417hypertonic pharynx and, 409–411inhalation method and, 392–393, 407–408,

411–412, 413injection method for obstruents (HMO), 392,

394–402, 412

injection method for sonorants and vowels(IMSV), 392, 402–407, 412

intelligibility and, 83, 84, 384–385, 673latency and, 412–413loudness and, 67–68, 423–424, 675multidimensional structure of alaryngeal speech

and, 128nasal resonance and, 415nonverbal behaviors and, 416–418, 424obstruents and air intake, 386–387oral reading rate for, 82, 83pharyngoesophageal (PE) segment and, 523–

526, 529–534pitch control, 423prevalence of use of, 77–79, 381production levels, 424–425prognosis for acquisition of, 383–384pulmonary function and, 600radiation therapy and, 597–598speech–language pathologist prejudice toward,

94–95, 103speech rate and, 382, 415–416, 422, 675sphincter tension and, 527–528statistics on usage of, 61–62training for, 384–386, 388–390, 418–419, 606,

675, 679vocal intensity and, 121–122voice consistency and, 408–411vowel hierarchy and, 387–388

Ethics, 707-708European Organization for Research and Treatment of

Cancer Core Quality of Life Questionnaire–Head and Neck Cancer Module (EORTCQLQ–H&N37; Bjordal Ahlner-Elmqvist),700

Family. See also Peer group supportcounseling overview and, 355–356emotional support and, 356–360group treatment models and, 648, 651homecoming preparation, 369–370information delivery to, 362–363postsurgery outpatient counseling, 370, 374quality of life (QOL) and, 710rehabilitation success and, 627

Fatigue, 505, 606, 651, 719, 724, 726Feedback, 389, 419–421, 684–685Flatulence, 498Follow up

flow-chart for postsurgery follow up, 271TEP voice prosthesis troubleshooting and, 483upper aerodigestive tract malignancy and, 150–

151Free flap procedures, 167-168


Frequency, 119-121Friends, 365-366Fronto-lateral laryngectomy. SeeVertical partial lar-

yngectomy (VPL)Functional Assessment of Cancer Therapy Scale (FACT-

G; Cella), 700Fundamental frequency, 119-121

Gastric pull-up procedure, 245-246, 257Gastroesophageal (GE) junction, 245Gastroesophageal reflux, 617-618GE. See Gastroesophageal (GE) junctionGender

decision making and, 713group treatment and, 648special needs of women, 100–102women-only support groups, 656

Glottal fricative, 415Glottic cancer

early glottic cancer, 173–182mid-sized glottic cancer, 183–184supraglottic cancer, 185–189

Goals for treatment, 359–360Granuloma, 488, 497–498Grief cycle, 70–72, 357Griffin Laboratories, 575Group treatment models. See also Counseling; Peer

group supportattendance and, 647–649, 654benefits of, 653clinical issues, 650–651common features of, 645–651common personal themes, 649–650five levels of, 642format and content of, 647head and neck cancer support groups, 655–656hospital-based laryngectomy support groups,

652–655individual versus group therapy, 687–688isolation and, 641, 644–645new voice clubs, 641–652objectives of, 646–647one-to-one peer support, 656organizational strategies for, 656–658overview of, 641–645recruitment of members, 647resources, 660termination of therapy and, 689topics for, 648women-only groups, 656

HBO. See Hyperbaric oxygen (HBO) prophylacti-cally

Head and neck squamous cell carcinoma (HNSCCa). See also Oral cancer definitionof, 263

Head and Neck Survey (H&NS; Gliklich, Goldsmith,& Funk), 700

Healing and the Mind (Moyers), 7Health, WHO definition of, 5Health-oriented model of care, 6-8Hearing loss, 147, 368, 383, 414, 417, 602Heat and moisture exchange (HME) systems

future developments for, 518overview of, 509–515pulmonary function assessment and, 508tracheoesophageal puncture (TEP) voice prosthe-

sis and, 444–445, 497voicing problems and, 514

Hemilaryngectomy, 228, 328–329History of Artifical larynx (AL). See also Artifical

larynx (AL)electronic larynx, 35–36illustrations of, 41–42, 44–48overview of, 30–36, 549–551timeline of, 36–49

History of laryngectomy procedure. See also Laryn-gectomy

biopsy and, 26, 28description of procedure, 20–23justification for surgery, 25-26life prolongation and, 24, 30overview, 19postoperative treatment, 26timing of surgery and, 23–25treatment advances timeline, 27–30

Holistic approach, 724–725Homecoming preparation, 369–370Hospital-based laryngectomy support groups, 652–

655Humiliation, 360Hunterian Society of London, 27Hyperbaric oxygen (HBO) prophylactically, 281,

283Hypopharyngeal stricture, 614, 616

IAL. See International Association of Laryngec-tomees (IAL)

ICF. See International Classification of Functioning(ICF)

ICIDH. See International Classification of Impairments,Disabilities, and Handicaps (ICIDH)

IMO. See Injection method for obstruents (IMO)

Imperial Academy of Sciences, 32Implant-supported prosthesis, 297–299, 587Implanted artificial larynxes (AL), 579–580


IMSV. See Injection method for sonorants and vowels (IMSV)

Indwelling voice prostheses. See Tracheoesophagealpuncture (TEP) voice prosthesis

Informed consent, 707Inhalation method

esophageal speech training and, 675latency and, 413nasal resonance, 415overview of, 392–393teaching of, 407–408voice quality and, 411–412

InHealth Technologies, 494Injection method for obstruents (IMO)

articulation and, 413esophageal speech training and, 675evaluation of, 676latency and, 413multiple injections, 417nasal resonance and, 415overview of, 392teaching of, 394-402voice consistency and, 409voice versus unvoiced obstruents and, 414

Injection method for sonorants and vowels (IMSV)

esophageal speech training and, 675evaluation of, 677latency and, 413multiple injections, 417nasal resonance and, 415overview of, 392teaching of, 402–407voice consistency and, 409

Intelligibility. SeeVocal intelligibilityIntensity. SeeVocal intensityInterim obturator, 288International Association of Laryngectomees (IAL),

61, 370, 373, 633, 634, 652, 660, 691International Classification of Functioning Disability and

Health (ICIDH–2), 7International Classification of Functioning (ICF), 7International Classification of Impairments, Disabilities,

and Handicaps (ICIDH), 7International Medical Congress, 24Intimacy, QOL and, 5Intraoral prosthetics, 335-337Inventory of Communication Attitudes, 98Iron-deficiency anemia, 263Isolation, 11, 71-72, 641, 644-645, 648

Jejunal free flap, 248-250Jitter, 200, 206-209, 303Journal of Laryngology and Rhinology, 23

Journal of the Acoustical Society of America, 35Journal of the American Medical Association, 35, 40

Kay Elemetrics, 304, 685Keratosis, 200, 205Kett Engineering Corporation, 36, 44

Langenbeck Clinic, 21LARKEL layngectomy snorkel device, 636Laryngectomy

justification for surgery, 25–26life prolongation and, 24, 30postoperative treatment historically, 26rehabilitation success and, 10timing of surgery, 23–24

Laryngopharyngectomy, 239, 241, 241–242Laryngopharyngeosophagectomy, 239Laryngoxerosis, 200Lateral thigh free flap, 251-252Leakage, 437, 455, 465, 467, 468-469, 487, 603Let’s Face It:A Network for People with Facial

Differences, 655, 660Leukoplakia, 200Listeners

esophagal speech (ES) and, 387impact of alaryngeal voice on listener, 117–118,

128–129, 133–136quality of speech and, 669

Listening, 358Living arrangements, 146–147Local flaps, 166Lost Chord Club, 108, 633, 634, 651–652, 691Loudness. SeeVocal loudness

Macrostoma, 487, 495Magnetic resonance imaging (MRI), 148, 272, 317Mandibular surgery, 276-277Manhattan Eye, Ear, and Throat Hospital, 39Massachusetts Eye and Ear Infirmary, 549–550Maxillofacial rehabilitation

chemotherapy and, 274clinical staging and, 264–266communication rehabilitation, 299-306defect obturation, 275–276dentistry and, 277–280, 282, 285functional assessment of patients needing, 307–

308implant-supported prosthesis, 297–299oral cancer management and, 267–277oral cancer overview and, 263–264osteoradionecrosis (ORN) and, 280–282overview of, 274posttreatment consequences of maxillary surgery

and, 274


prosthetic management, 282–293radiation therapy and, 274, 280–282soft palate defect prosthetic rehabilitation, 294,

296surgery and, 274, 276–277therapeutic limitations and, 266tongue defect reconstruction, 295–296

Mayo Clinic, 35Mayo Clinic Postlaryngectomy Questionnaire, 104MBS. See Modified barium swallow (MBS)Medic-Alert bracelet, 373Metastasize, 197Microstoma, 487, 494–495Mid-sized glottic cancer, 183–184. See also Oral

cancerModified barium swallow (MBS), 325, 485Mountain Precision Manufacturing, 575Mouth surgery, 276–277Mouth-type artificial larynxes (AL), 576–579MRI. See Magnetic resonance imaging (MRI)Mucositis, 204Myotomy, 490, 536

Nasalance, 304Nasometer, 304National Commission for the Protection of Human

Subject of Biomedical and Behavioral Re-search, 707-708

“Nature and Cause of Pulmonary Affections Pro-duced by Bilateral Vagal Section” (Weir), 21

Near-total laryngectomy (NTL), 230–231Neck-type artificial larynxes (AL), 551–554, 574–

576, 577, 585Needs communication, 716–718Neoglottic tonicity, 616Netherlands Cancer Institute, 474New Voice Club, 633, 651–652, 691Non-indwelling voice prostheses. See Tracheo-

esophageal puncture (TEP) voice prosthesisNonsurgical treatment of laryngeal carcinoma. See

also Conservation larygectomy procedures;Surgery

chemotherapy, 202–204malignancy development and, 197–198organ preservation and, 105perceived voice attributes and, 210posttreatment management, 211radiation therapy, 201–202vocal tract effects of, 204–210

Nonverbal behaviors, 416–418, 424–425, 564,675

Nonvocal communication, 81, 86NTL. See Near-total laryngectomy (NTL)Nu-Voice Club, 70

Obturation. See Defect obturationOcclusive spasm, 534Occupational functioning, QOL and, 5Oncogenes, 197One-to-one peer support, 656Oral articulatory evaluation, 305–306Oral cancer. See also Early glottic cancer; Glottic

cancer; Mid-sized glottic cancer; Supra-glottic cancer; Treatment options

chemotherapy and, 266, 274clinical staging, 264–266demographics and incidence of, 263diagnosis and, 267–272etiology, 263–264examples of, 272imaging and, 272management of, 267–277overview of, 263palliative treatment, 273prognosis and, 273radiation therapy and, 266, 274rehabilitation, 273risk factors for, 263–264squamous cell carcinoma and, 267surgery and, 266, 274therapeutic modality limitations, 266treatment sequence, 270tumor, node, and mestastasis (TNM) and, 264–

267Oral-motor and communication function assess-

ment, 301-306Oral reading rate, 82Oral Vibrator, 36, 42, 46Organ preservation, 105-106ORN. See Osteoradionecrosis (ORN)Osteoradionecrosis (ORN), 280–282, 318, 338Outcomes of speech rehabilitation. See also Treat-

ment successcommunication proficiency, 81–84overall communication functioning, 84–86overview of, 77prevalence of modes of alaryngeal communica-

tion, 77–81speech acquisition, 94–96

Overarticulation, 561–563

Palliative treatment, 273Partially edentulous individual, 290–291Patient history, upper aerodigestive tract malignancy

and, 145–147PE. See Pharyngoesophageal (PE) spasmPectoralis major flap, 246–248, 278Peer group support. See also Counseling; Family;

Group treatment models


alaryngeal speech activities, 635altruism and, 630attendance and, 631benefits of, 627–629counseling and, 637facilitator role in group speech therapy, 631–632goals and, 632mechanics of, 629–631metacommunication skills and, 635–636one-to-one peer support, 656overview of, 627overview of speech therapy groups, 632–635psychological adaptation and, 628, 636social laryngectomy clubs, 633–635topics for group therapy, 635–637universality and, 630

Pharyngeal wall resection, 331Pharyngocutaneous fistula, 490Pharyngoesophageal (PE) segment function

alaryngeal voice generation and, 523–524cricopharyngeal spasm and, 533–535esophageal speech (ES) and, 523–526, 529–534myotomy of phyrngeal constrictor muslces, 536neurological control of, 527–528overview of, 523PE spasm, 64, 533–537pharyngeal plexus neurectomy, 536structure of, 524–527surgical and medical treatment for voice failure,

535–537TE speech and, 523, 538, 679-680tracheoesophageal puncture (TEP) and, 523,

528–529Pharyngoesophageal (PE) spasm, 64, 533–537Phonatory evaluation, 302–303Pitch. SeeVocal pitchPlummer-Vinson syndrome, 263Pneumonia, 21, 29, 30, 93, 146Postfitting aphonia, 485, 489–490Postoperative inpatient counseling, 368–369, 373Postsurgery outpatient counseling, 370, 374Postures for assistance in swallowing, 326, 335Primary closure, 165Prosthetic management

for edentulous and mandibulectomized individ-ual, 293–294

for edentulous individual, 291–292implant-supported prostheses, 297–299for partially edentulous individual, 290–291for partially edentulous mandibulectomized indi-

vidual, 292–293presurgical dental assessment and management,

282, 286prosthetic rehabilitation, 287–290

surgical obturators, 275–276, 287–290swallowing disorders and, 335–337

Provox extended-wear voice prosthesis, 483Provox HME device, 514Provox Stomafilter System, 497Psychological issues. See also Self-esteem

anxiety, 12, 641, 646, 649, 711attitude toward health care professionals and,

714–716coping and, 649–650depression, 71, 72, 641, 649, 710, 711, 724, 744intervention and, 642isolation, 11, 71–72, 641, 644–645, 648overview of psychiatric morbidity, 5–7peer support and, 628psychological distress, 130, 646psychosocial distress, 6, 130, 641, 720, 726quality of life (QOL) and, 710–712screening for, 720–722treatment success and, 10–11verbal communication and, 5, 11–12, 595, 636

Psychosocial Adjustment to Illness Scale (PAIS;Derogatis & Lopez), 103

Pulmonary function, 507-510, 600-602

Quality of life (QOL)adaptation of rehabilitation and, 723artificial larynx (AL) and, 727assessment of, 699–703, 718–722coping styles and, 713–714decision making and, 712–713definitions of, 699, 743dimensions of, 5educational materials and, 709emotional adjustments and, 357ethical perspective and, 707–708future research directions, 725–729group treatement models and, 646health assessment and, 699–703holistic approach and, 724–725impact of disease on, 12–13, 641, 643, 703–706isolation and, 11needs communication and, 716–718outcome measures and, 701overview of, 699patient attitudes about health professionals and,

714–716patient knowledge and, 708–710patient participation in rehabilitation and, 723–

724physical disfigurement and, 361physical problems and, 712psychosocial difficulties and, 710–712reasons for patient nonassertion about, 708–718


sexuality and, 5speech-language pathologists and, 706–707, 711,

718–725successful total rehabilitation and, 97survival duration and, 8treatment options and, 155–156, 273treatment success and, 104–109, 748

Radial forearm flap, 167–168, 250–251Radiation therapy

alaryngeal speech development and, 597–599brachytherapy, 159–160dental issues and, 318depression and, 711dysphagia and, 595, 597, 601–602limitations of, 266overview of, 201–202posttreatment management of vocal symptoms,

211side effects of, 157–159, 204–210, 266, 280–282,

331, 337–340, 414, 595, 597–598supraglottic tumors and, 227surgery compared with, 156–157swallowing disorders and, 337–340tracheoesophageal puncture (TEP) voice prosthe-

sis and, 437, 475Rand Development Corporation, 45Rate. See Speech rateReconstruction

cervical rotation flaps and, 241–242deltopectoral flap (DP) and, 243–245dentistry and, 277–280, 282, 285extended laryngectomy and, 239–241gastric pull-up procedured, 245–246jejunal free flap and, 248–250lateral thigh free flap and, 251–252overview of, 239–241pectoralis major flap and, 246–248, 278radial forearm free flap and, 250–251reconstructive options, 162–168supracricoid partial laryngectomy with recon-

struction (SCPL) and, 232swallowing and, 239tissue overview, 252–254verbal communication and, 184, 254–258

Regional flaps, 166-167Rehabilitation in head and neck cancer. See also

Counseling; Group treatment models; Max-illofacial rehabilitation; Peer group support;Speech-language pathologists; Treatmentsuccess

biopsychosocial model, 7–9, 724–725, 743–745clinical program expansion, 740–741current status of, 739–740

emergent themes in, 750emotional support and, 356–360facilitation of, 747–750goals and, 359–360, 632, 668, 670–680grief cycle and, 70–72, 357lifestyle alteration and, 749multidimensional constructs, 743–745new care paradigm, 745–746overview of, 739programs of care, 741–742psychological issues, 744, 750psychosocial impact of cancer, 746–747support groups for, 652–656

Resonatory evaluation, 303–305Respiratory issues. See Total laryngectomy respira-

tory consequencesRomet, 575

Salivary flow. See XerostomiaScintigraphy, 319-320SCPL. See Supracricoid partial laryngectomy with

reconstruction (SCPL)Secondary TEP voice restoration, 462, 465Self-esteem

as affected by disease, 12alaryngeal speech development and, 595coping and, 649friendship maintenance and, 366head and neck cancer and, 641patient attitude toward health care providers and,

716physical disfigurement and, 361

Self-Evaluation of Communication Experiences AfterLaryngectomy (SECEL; Blood), 103

Self-induced isolation. See IsolationSexuality, 5SGL. See Supraglottic laryngectomy (SGL) proce-

dureShimmer, 200, 206–209, 303Siemens, 575Singer and Blom duckbill prosthesis, 438Sleep disturbances, 505, 711, 716Smell sense, 602Smoking and tobacco, 197, 200, 205, 263, 600, 749Social context of communication, 115Social isolation. See IsolationSocial laryngectomy clubs, 633–635Soft palate defect, 294, 296Speech. SeeVerbal communication; headings begin-

ning VoiceSpeech-language pathologists. See also Accountabil-

ity in alaryngeal speech rehabilitation;Counseling; specific types of alaryngealspeech


conversation starters, 375–376counseling and, 318–319, 340, 355–356functional assessment of patients needing max-

illofacial prosthodontics and, 307homecoming preparation, 369–370hospital-based laryngectomy support groups and,

652-653information delivery and, 362–363intraoral prosthetics and, 336–337lesson planning, 680, 682–688organ-preservation treatments and, 340postoperative inpatient counseling and, 368–369,

373postoperative outpatient counseling, 370, 374posttreatment intervention and, 319preoperative counseling and, 366–368, 372, 458quality of life (QOL) and, 706–707, 711, 718–

725role of, 300, 355–356, 667swallowing disorders and, 317termination of therapy and, 689, 691therapy logs and, 688–689therapy session elements, 686–688tracheoesophageal puncture (TEP) voice prosthe-

sis and, 458–461, 483trust establishment and, 360–362

Speech rate, 69–70, 382, 415–416, 422, 448, 670,675

Spirituality, 5Split-thickness skin grafts, 165–166SPOHNC. See Support for People with Oral and

Head and Neck Cancer (SPOHNC)Spouses, 363–366Squamous cell carcinoma, 267St. Boniface Hospital, 656Stages of loss, 70–72Stigmatization, 746–747Stomal stenosis and irregularity, 616–617Stomatitis, 204Stridor, 199Stutter, 98, 368Successful total rehabilitation, 96–102, 109Suffocation, 23Suicide, 357, 716Support for People with Oral and Head and Neck

Cancer (SPOHNC), 655, 660Supracricoid partial laryngectomy with reconstruc-

tion (SCPL), 231–232Supraglottic cancer, 185–189. See also Oral cancerSupraglottic laryngectomy (SGL) procedure, 226–

228, 329-330Surgery. See also Nonsurgical treatment of laryngeal

carcinoma; Reconstruction

alaryngeal speech development problems and,603–605

dentistry and, 277–280, 282, 285dysplasia and, 173–184early glottic cancer and, 173–184limitations of, 266mandibular surgery, 276–277maxillary surgery, 274–275mid-sized glottic cancer and, 183–184mouth surgery, 276–277overview of, 160–162postoperative inpatient counseling and, 368–369,

373preoperative counseling, 366–368, 372, 458radiation therapy compared with, 156–157supraglottic cancer and, 185–189supraglottic tumors and, 227swallowing disorders and, 331–335tongue surgery, 276tracheoesophageal puncture (TEP), 458–461,

463–464vocal fold atypia and, 173–184

Surgical reconstruction. See ReconstructionSurvivability, 8, 93–94, 267Swallowing disorders

aspiration and, 329counseling and, 318–319, 340exercises for, 329, 330, 334, 335hemilaryngectomy and, 328–329intraoral prosthetics, 335–337maneuvers for altering swallow physiology, 327normal swallowing, 320–325obdurators and, 337pharyngeal wall resection and, 331posttreatment intervention and, 319–320postures for assistance in, 326, 335pretreatment rehabilitation considerations, 317–

318radiation therapy and, 337–340, 601–602radiographic evaluation and, 325–328rationales for appropriate bolus types, 327scintigraphy and, 319–320supracricoid partial laryngectomy with recon-

struction (SCPL) and, 232supraglottic laryngectomy and, 329–330supraglottic laryngectomy (SGL) procedure and,

227–228surgical treatment and, 161, 189, 239, 331–335swallowing evaluation, 306total laryngectomy and, 330–331ultrasound and, 319–320videoendoscopy and, 319–320videofluoroscopy and, 319–320


Swimming, 636Syphilis, 20, 28

TE. See Tracheoesophageal (TE) speechTeeth, 161Telephone communication, 84Templin-Darley Tests of Articulation (Templin &

Darley), 305TEP. See Tracheosophageal puncture (TEP)Termination of therapy, 689, 691Therapy logs, 688-689Therapy report outline, 690Thrush, 204Tissue overview, 252-254TNM. See Tumor, node, and mestastasis (TNM)Tobacco. See Smoking and tobaccoTokyo artifical larynx, 134Tongue-base exercises, 329, 334, 335Tongue defect reconstruction, 295–296Tongue-hold maneuvers, 329Tongue surgery, 276Total laryngectomy, 330–331, 603Total laryngectomy respiratory consequences

coughing, 505heat and moisture exhange (HME) system and,

508–515, 518medical treatment and, 515–518overview of, 505–506phlegm production, 505–506pulmonary function assessment, 507–510stoma breathing effects, 506–507

Total laryngopharyngectomy, 239, 241–242, 604Total laryngopharyngoesophagectomy, 604Tracheoesophageal puncture (TEP), 62, 79, 95, 106,

256–257Tracheoesophageal puncture (TEP) voice prosthesis

acquisition success factors, 456, 458alcoholism and, 437candida albicans and, 455, 467–468, 474, 493candidacy for, 436–437, 599care and cleaning of, 443, 473, 484–485chronic peritracheal and, 436complications associated with, 434, 436device selection, 442disappearance of, 470–471esophageal insufflation testing and, 437–438, 439fitting of, 441granulation tissue and, 469–470, 488, 610heat and moisture exchange (HME) and, 444–

445illustration of, 435indwelling versus non-indwelling protheses, 455–

456

infection and, 469–470leakage and, 437, 455, 465, 467, 468–469, 487,

609manual dexterity and, 602–603obstruction and, 465overview of, 433–434, 455–456pharyngoesophageal (PE) segment and, 523, 528–

529preoperative counseling and, 458problems related to, 609–613prosthesis types, 438, 440radiation therapy and, 437, 475replacement of voice prosthesis, 465–471secondary TEP voice restoration, 462, 465sound production and, 434speech rate and, 448speech therapy and, 471–473surgical procedure for, 458–461, 463–464timing of placement of, 442–443, 456, 458,

606tonicity of PE segment and, 456, 461tracheostoma breathing valve, 443–445tracheostoma construction and, 462training for, 443, 473, 607

Tracheoesophageal puncture (TEP) voice prosthesistroubleshooting

botox and, 490cleaning and care and, 484–485delayed dysphonia and, 491–492delayed postfitting aphonia and, 486duration insufficiency, 488dysphonia and, 491–492effortful speech, 490–491gastric air excesses, 498granuloma, 488, 497–498, 610leakage, 487, 492–493macrostoma, 487, 495microstoma, 487, 494–495overview of voice problems, 473–475, 483–485postfitting aphonia and, 485, 486, 489–490procedure candidates, 483, 484–485prosthesis deterioration and, 493–494radiation therapy and, 598speech quality, 488–489troubleshooting guide, 486–489valve problems, 495–497

Tracheoesophageal (TE) speech. See alsoVerbalcommunication

articulation and, 66, 680assessment of, 615, 679–680, 681average communication profile score and, 86Botox and, 608, 613communication problems and, 84–85


compared with other types of alaryngeal speech,61–62

consistency of voicing, 670cricopharyngeal spasm and, 533–535, 608descriptive aspects of, 118distractors and, 63–65fluency protocol, 615fundamental frequency and, 119–121intelligibility, 83, 84, 447–448, 475long-term effects of, 106–107occlusive spasm and, 534oral reading rate for, 82, 83overview of, 79–81patient training in, 446–448pharyngoesophageal (PE) segment and, 523, 679–

680placement of speech aids and, 63preference rate for, 80–81problems related to, 609–612pulmonary function and, 601radiation therapy and, 598–599reconstruction and, 256–257spasm and, 533–535, 608, 613–614speech therapy, 471–473statistics on usage of, 61–62vocal intensity and, 121–122vocal loudness and, 67, 448, 610vocal pitch and, 447–448voice quality and acceptability and, 123–124, 499

Trainingfor artifical larynx (AL), 556–564for esophageal speech (ES), 384–386, 388–390,

418–419, 606, 675, 679feedback and, 389, 419–421, 684–685lesson planning, 680, 682–688for tracheoesophageal puncture (TEP) voice

prosthesis use, 443, 473, 607for tracheoesophageal (TE) speech, 446–448variable practice and, 685-686

Treatment optionsfree flap procedures, 167–168limitations of, 266local flaps, 166overview of, 155primary closure, 165principles of treatment, 155–156QOL and, 155–156radiation therapy, 156–160reconstructive options, 162–168regional flaps, 166–167split-thickness skin grafts, 165–166surgery, 160–162

Treatment satisfaction, QOL and, 5Treatment sequence, 270

Treatment success. See also Outcomes of speech re-habilitation; Quality of life (QOL)

artificial larynx and, 566–567biopsychosocial model and, 743–745communication satisfaction and, 98–100counseling and, 100–102, 108definition of, 5factors contributing to, 129–133gender and, 100–102laryngectomy and, 10organ preservation and, 105–106overview of, 93patient attitude and participation and, 102–103,

108–109, 723–724patient history and, 146–147psychological issues and, 6, 10–11, 130self-esteem and, 355speech acquisition and, 94–96successful total rehabilitation, 96–102, 109survivability and, 8, 93–94, 267

Trismus, 148, 334, 338Trust establishment, 360–362Tumor, node, and mestastasis (TNM), 264–267

Ultrasound, 319–320UNI Manufacturing Company, 575Universality, 630University Göttingen, 21University of Sydney, 37University of Washington QOL Questionnaire

(UW–QOL; Hassan & Weymuller), 700Upper aerodigestive tract malignancy

clinical examination, 147–150overview of, 145patient history and, 145–147posttreatment follow-up, 150–151pretreatment evaluation, 145–150rehabilitation success and, 146

VA Rehabilitation Research and DevelopmentGrant, 580

Verbal communication. See also Artifical larynx(AL); Communication; Esophageal speech(ES); Tracheoesophageal (TE) speech;headings beginning Voice

aging and, 200chemotherapy and, 204–205counseling and, 299endoscopic technique and, 179–182, 188–189glottic reconstruction and, 184jitter and, 200, 206–209, 232laryngeal carcinoma and, 198–201low voice, 257nasalance and, 304


near-total laryngectomy (NTL) and, 231nonsurgical treatments and, 204–210oral communication assessment, 299–300oral–motor and communication function assess-

ment and, 301–306outcome measures, 306–308psychiatric morbidity and, 5, 11–12reconstruction and, 184, 254–258shimmer and, 200, 206–209, 232speech–language pathologists and, 300, 307supracricoid partial laryngectomy with recon-

struction (SCPL) and, 232surgery treatment and, 161vertical partial laryngectomy (VPL) and, 229voice and speech rehabilitation, 10voice consistency and, 408–411

Vertical partial laryngectomy (VPL), 228–229Videoendoscopy, 319-320Videofluoroscopy, 304, 319-320, 484Videonasendoscopy, 340Visual acuity, 602Vocal fold atypia

disease presentation, 173endoscopic technique and, 178–179management philosophy, 173–176vocal outcome and, 179–182

Vocal intelligibilityartificial larynx (AL) and, 82, 83, 566, 578, 581,

582, 584esophageal speech (ES), 82–84, 384–385, 673radical surgery and, 603tracheoesophageal (TE) speech and, 83, 84, 447-

448, 475voice and speech perception, 122–124

Vocal intensity, 121–122Vocal loudness

alaryngeal speech and, 63artificial larynx (AL) and, 67–68, 581esophageal speech (ES) and, 67–68, 423–424, 675tracheoesophageal (TE) speech and, 67, 448, 610

Vocal pitch, 69, 423, 447-448, 581Vocophone, 40Voice and speech perception. See alsoVerbal com-

municationaging and, 200descriptive aspects of alaryngeal voice and

speech, 118–127, 131–132durational measures and, 122fundamental frequency and, 119–121impact of alaryngeal voice on listener, 117–118,

128–129, 133–136intelligibility and, 122–124intensity and, 121–122interrelationships of physical and perceptual

measures, 126–127multidimensional structure of alaryngeal speech,

127–128nature of alaryngeal speech and, 116–117nonsurgical treatment and, 210overview of, 115–116participation restrictions, 115–116rehabilitative success and, 129–133vocal intensity and, 121–122voice quality and acceptability, 123–125

Voice boxes. See Artificial voice boxesVoice consistency, 408–411Voice quality and acceptability, 123–125, 499Voice rehabilitation, nonsurgical treatment of laryn-

geal carcinoma and, 197–198VPL. SeeVertical partial laryngectomy (VPL)Vulnerability, 650, 726

W. M. Keck Neural Prosthesis Research Center, 585Western Electric Company, 34, 35, 39, 40–42, 47,

574Why Me? (Gargan), 369World Health Organization (WHO), 115, 699, 701,

743

Xerostomia, 159, 280, 338


Subject Index - proedinc.com · speech therapy and,605–606 ... Deﬁnitive obturator,289 Delayed...

Documents

Transcript of Subject Index - proedinc.com · speech therapy and,605–606 ... Deﬁnitive obturator,289 Delayed...