A speech therapist has a vital role in the pre- and post op management of laryngeal cancer, because Laryngectomy patients have to undergo speech management. So here are some of the things to know about laryngectomy.
A Team Approach
Firs off, the management of laryngeal cancer requires a team approach. The patient gets to see a surgeon, radiologist, audiologist, speech-language pathologist, oncologist, physical therapist, maxillofacial prosthodontist, and a psychiatrist. All of these health care professionals work together to work on the management of the patient.
What Is Laryngectomy?
Laryngectomy is the total removal of the larynx. It is also the partition of the airway from the nose, mouth, and esophagus. A person that undergoes this kind of operation would have to breathe via an opening on the neck, called stoma.
Laryngectomy is done when a person has laryngeal cancer. It may be considered to be a traditional way of managing laryngeal cancer, since a lot of laryngeal cancer cases nowadays are treated with the use of chemotherapy, radiation, or other laser procedures. In severe cases that these don’t work, that is the only time laryngectomy is opted for.
Other than the larynx, other structures are also removed. These other structures includes Sternocleidomastoid, Omohyoid muscle, Internal Jugular vein, Spinal Accessory vein (CNXI), Submaxillary salivary gland. In most severe cases, the external carotid artery, strap muscles of the neck, Vagus nerve (CN X), Hypoglossal nerve (CN XII) and the lingual branch of the Trigeminal nerve (CN V) are also removed.
How Common Is Laryngectomy?
It is estimated by the American Cancer Society, in 2003, that around nine thousand five hundred people in the US were diagnosed of laryngeal cancer. This condition occurs about 4.4 times more predominantly with men than with women. Though, similar with lung cancer, laryngeal cancer is becoming increasingly frequent with women.
Tobacco smoking is so far the supreme risk factor in having laryngeal cancer. Other factors include radiation exposure, asbestos exposure, alcohol abuse, and genetic factors. In United Kingdom, laryngeal cancer is rather rare, since it only affects less than 3,000 people per year.
After total Laryngectomy, possible problems may occur. These include having a scar tissue at the tongue base, narrowing of the esophagus, partial tongue base resection, dysphagia, Xerostomia, mouth sores and changes in smell, taste, appetite and weight.
Effects And Impacts Of Laryngectomy
Laryngectomy has two mechanistic effects. One, it separates respiration from speech. Two, it keeps the pharyngoesophageal region intact.
There are also impacts that Laryngectomy brings about. The main impact would be the loss of voice for communication. You may also lose the ability to express emotions such as laughing. You also get physical problems with regard to tasting and feeding.
Laryngectomy is frequently successful in treating early-staged cancers. Still, undergoing through the procedure would require major lifestyle change. There is also a risk of having severe psychological stress due to unsuccessful adaptations.
After The Procedure: Voice Replacement And Care
After the patient’s larynx is removed, voice prosthetics is used. This serves as a replacement for the lost larynx, so that the person will still be able to communicate and speak. In this case, Laryngectomees would have to learn new methods of speaking.
They should also be constantly concerned in taking care and cleaning their stoma. Severe problems can arise if foreign materials and water enter their lungs via their unprotected stoma.
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nnnnnImproving Talk Through TelemedicineWABITowey is the manager of the Voice and Swallowing Center of Maine in Belfast. He has ... Two years ago, the Searsmont man had his voice box removed due to cancer. In fact ... Towey is working with clinical specialist Lindsey Lambert Gordon whose showing ...nnn
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Voice training is done to find an appropriate source of sound production that can be articulated for communication purposes. Criteria for selecting sound source include: degree of tissue loss, esophageal stenosis, physical limitations of the patient; noise level of the patient’s environment; motivation level; and patient’s preference of sound source.
Types Of Sound Source
There are mainly three types of sound source a patient can choose from. These are: external man-made prosthesis or artificial larynx; sphincter like junction of the pharynx and esophagus or esophageal speech; and lastly, surgically implanted device or transesophageal puncture and silicon prosthesis.
The principle of artificial larynx is to have an external mechanical sound source that is substituted for the larynx. Anatomic structures for articulation and resonance are most of the time unaltered.
There are two general types of electrolarynges that are available: neck type and intra oral type. The neck type is placed flush to the skin on the side of the neck, under the chin, or on the cheek. Sound is conducted via the oropharynx and is articulated normally.
The intraoral type is used for patients that can’t conduct sound through skin adequately. A small tube is placed toward the posterior oral cavity, and the produced sound is then articulated. The tube has little effect on articulatory accuracy if the patient is taught properly and learns to use it well.
The advantage of artificial larynx is that voice is restored after surgery immediately and the maintenance of the hardware is minimal. The disadvantage however, is that the quality of sound may seem mechanical.
The principle behind esophageal speech is that air is of greater pressure in one chamber (oral cavity) will flow to a chamber containing less pressure (esophagus), if these chambers are connected.
Goals of esophageal speech include: to be able to phonate upon demand, use a rapid method of air intake, short latency between air intake and phonation, produce four to nine syllables per air charge, achieve a speaking rate of 85-129 words per minute, and attain good speech intelligibility.
There are mainly three methods of esophageal speech. Injection is a method where air in the mouth/nose is compressed by lingual or labial movement and is injected into the esophagus. Swallowing method uses air that enters during oral opening when swallowing. The air is used to produce voice.
Inhalation method maintains a patent airway between the nose, lips and esophagus. The stoma is used for inhalation. Air enters the esophagus when the pharyngo-esophageal muscle is relaxed during inhalation.
The advantage of this kind of speech includes: no external devices, natural sounding speech, and the possibility of pitch and loudness control. Disadvantages on the other hand are: there is reduced length of utterance, is hard to learn and requires good articulation.
This is another approach to voice restoration. It requires a surgical/prosthesis procedure that makes use of a man-made device inserted into a surgically created midline transesophageal fistula.
Air is conducted from the trachea to the esophagus through the prosthesis to excite the pharyngo-esophageal segment for voice production.
Advantages include: rapid restoration, natural sound, normal utterance length, hands-free, minimal maintenance and intelligible tonal language. Disadvantages are: the need for surgery, puncture stenosis, candida growth, aspiration of foreign objects, and troubleshooting.
Laryngectomy support group to meet Thursday - WKTV
nnnnnLaryngectomy support group to meet ThursdayWKTVThe meeting will be at noon Thursday in the Sister Regina Conference Room at St. Elizabeth Medical Center in Utica. A laryngectomy is the procedure to remove a person's larynx and separates the airway from the mouth, noise and esophagus. The public is ...nnn
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Many wonder why anyone would practice self-injury, as it is painful and dangerous. However, with autistic children, self-injury occurs more often than not. There are several theories as to why this practice can be prevalent in autistic children, and there are some methods you can use to help ease this distressing practice.
Because autistic children are unable to communicate through language the way that others can, they often feel frustrated at not being understood or at not getting what they need or want. Thus, autistic children may commit self-injury, by banging their heads or biting themselves (among other tactics), to release some of that frustration that cannot be communicated through words. Also, self-injury is a way of getting attention. An autistic child’s frustration goes hand-in-hand with wanting attention. For instance, by scratching oneself until one bleeds, the autistic child will immediately get someone’s attention, and this person will work to understand what the child wants or needs.
This theory of frustration and attention has been the sole thinking for quite some time. Recently, however, studies have shown that self-injury can have a biochemical component that relieves some of the pain and frustration one feels by releasing endorphins, or “happy hormones,” into one’s system. The endorphins also provide a release for the autistic child, allowing him or her to temporarily forget about his or her frustration and pain. Furthermore, it is believed that if one practices self-injury enough, the endorphins will begin to help mask any pain associated with such behavior, making it an addictive action.
While some professionals say that ignoring the autistic child’s self-injurious behavior is an acceptable method of treating such practice, this can obviously be very difficult. Others have suggested that communication therapy and drugs may help an autistic child by providing him or her with another method of communication. There are drugs that will help stem the addictive behavior of releasing endorphins into the system, and thus help stop such behavior. There are also nutritional solutions available; vitamin B6 and calcium have been said to help many families with an autistic child.
For the family members involved, communication training to learn how to communicate with an autistic child is also extremely important. Because normal adults, and even children and teenagers, are so accustomed to communicating through easily recognizable words or body language, they have to learn that communicating with an autistic child requires a completely different process. By looking for solutions for both the family and the autistic child involved in self-injurious behavior, one may be able to overcome this distressing practice.
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Schedules are an important part of every child’s life. This is especially true when dealing with a child of special needs like Autism. Having a schedule will help the Autistic child feel a sense of structure. Children with Autism often have anxiety issue they are dealing with. Having a schedule helps the levels of anxiety to drop. They know what to expect on a daily basis. They know at a certain time of the day what they will be doing.
If there is no schedule or structure in an Autistic child’s daily life things will be very hectic. An Autistic child has lots of doctors and therapist appointments. Sometimes there will be more than one appointment a day. Keeping a schedule can help you and your child to make sure they do not miss any appointments.
Some Autistic children have trouble with reading. You can use a visual schedule. Have pictures for all the daily activities. This allows them to see what is coming next. Having a schedule for your Autistic child will help avoid some breakdowns. Keep the schedule posted where your child can see it. If you have to change the schedule explain the changes to your child. Autistic children like routines, and a change could throw their whole day out of whack.
Schedules can be a help when trying to get the child to do something they do not want to do. Simply show them that after they do this they will get to move onto something else. Tell them they cannot move on until this activity is completed.
There will always be things that come up. Try to stick to the schedule as much as possible. When things come up try to get back on schedule as soon as you can. This includes weekends . If your child is used to getting up at seven in the morning continue to do so. Keep their bedtimes close to the same time each night. Your Autistic child will be happier when they have had enough sleep.
Schedules will make life much easier you and your Autistic child. Keep them posted for your child to see, and stick to the schedule the best you can. An example of a schedule you can use if found below.
7 AM Wake up, get dressed and ready for the day 8 AM Breakfast 9 AM Therapy Appointment at home 11 AM Free time/ Play time 12 PM Lunch 1 PM Outdoor Play 2 PM Arts and Crafts 3 PM Free Time 5 PM Dinner 6 PM TV time 7 PM Bath time 8 PM Bed Time
This allows the child to know what is going on during the day. Include doctors, or therapy appointments on the schedule. An older child can still benefit from a schedule. It has to be adjusted for school time, and any extra curricular activities. You can include homework time, and chores into the chart. Once you start using a chart for your Autistic child you will see a improvement in the flow of your day. This also leaves little time for boredom. There is always something planned to do.
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Aspergers is a form of Autism. People with Aspergers syndrome are on the higher end of the spectrum. They usually have normal language skills. Their main problem is dealing with people socially. Usually these problems are first noticed when a child begins school. The child can have all the signs of Aspergers, or only a few. Here are some of the common signs of Aspergers syndrome.
1. Have a hard time talking to other kids. Kids with Aspergers syndrome have a hard time going up to someone and starting a conversation.
2. Speak in words that are very advanced for their age. The Asperger’s child may use words that adults would use.
3. Have trouble understanding when someone is joking, or being sarcastic. Children with Aspergers have a hard time understanding tones of people’s voices. They tend to take everything said seriously.
4. Have very limited interests. A child with Aspergers syndrome may only want to focus on one thing. They may take a liking to puzzles, and only want to do puzzles all the time. They will often learn everything they can about one subject. That will be all they focus on.
5. Have a hard time with changes in their routine. This can be hard for a child starting school. They had a routine at home and now that is being changed. The same thing can happen during breaks during the school year. This is a common problem of Autistic children.
6. Talking a lot. Children with Aspergers usually talk a lot. They often say whatever they are thinking whether it is appropriate or not. Most of the conversations they have are one sided. While it looks like the child is talking to you, they are really talking at you.
7. Problems making friends. Kids with Aspergers have trouble making friends due to their inability to relate to the other children. They sometimes try to hard to make friends and scare the other kids away.
8. No eye contact. Children with Aspergers usually will not look you in the eye when speaking. This is another common trait of an Autistic child.
9. Using repetitive movements. This can be a movement like spinning around, or bouncing back and forth while sitting. These movements are calming to the Aspergers child.
10. Problems with speaking. The Aspergers child may speak really fast. They usually do not stop to see if the person they are talking to is paying attention. Their tone of voice is flat and does not change to show emotions.
11. Problems with movement. Children with Aspergers often have trouble with their coordination skills. They may always be tripping or stumbling over their own feet. They may take a long time to learn how to ride a bike.
Asperger children have the most positive outcome on the Autism spectrum. They have high intelligence and language skills. They can often be taught the social skills they need to get by. If you notice any of these signs in your child mention them to the doctor.
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Many parents hope that in finding a source of autism, this disorder can be cured or prevented. Unfortunately, scientists have yet to find one single reason why children develop autism. It is possible that someday autism will be linked to a specific gene abnormality, but the more likely source is not one thing, but a number of factors in a child’s world. Autism cannot be prevented or cured, so the best we can do to help autistic children and adults is be understanding and willing to compromise to make the world comfortable for them and ourselves.
First off, there are certain things that do not cause autism, and these myths should be laid to rest immediately. Most importantly, bad parenting does not cause autism. In the past, mothers were blamed for traumatizing their children with cold parenting techniques, which was thought to lead to autism. This is simple not true. Autism is also not caused by malnutrition, although food allergies occur in my autistic children and some autistic children do benefit from taking daily vitamins.
There are many links between autism and the brain. Most people with autism have larger brains and they are “wired” differently than a typical brain. Differences occur in many parts of the brain, so it cannot be targeted to one specific brain malfunction overall, but rather a brain malfunction in general. Autistic children also show signs of an immune deficiency. Evidence in this study is not yet strong, but research is still being done. Many autistic individuals have other health problems related to immune deficiencies. Overall, these things all seem to point to genetics. Although autism is not the parents’ fault, it is most likely that autism was found elsewhere on your family tree, and it is not uncommon for parents to raise more than one autistic child. Autism may also be linked to vaccinations, although this is still being highly studied. The benefits of vaccinations greatly outweigh the risks of them causing autism, so you should not deprive your child simply because you are fearful. Talk to you doctor if you have concerns about vaccinations.
Nobody knows what causes autism. Therefore, we can do nothing to prevent and cure it, but rather we can simply treat the autistic people in our lives with the best of our ability. Becoming educated in autism is the key-the more you know about the disorder, the better you can help individuals who suffer from it. Autism is a complex problem, and as researchers develop new understandings of the way it affects the body, better treatment options will become available, with the hope that someday we will be able to cure this disease.
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The needs of an Autistic child can make photographing them very difficult. They can have a hard time sitting in one position, or have sensory issues with bright lights. Here are some tips for getting the perfect picture of your Autistic child.
1. If you are going to a photographer make sure you let them know ahead of time your child is Autistic. Let them know of any issues with bright lights, or problems sitting still. This will give them time to make some changes if need be.
2. Take pictures of your Autistic child at home, or on outings. A picture does not have to be taken by a professional to be good. If your child has a hard time sitting still get a picture of them while they are sleeping.
3. Take our child to get their picture taken during good times of the day. If you know that afternoons are usually filled with temper tantrums ad meltdowns make the appointment for first thing in the morning, or another time your child is more relaxed.
4. If your child has a special toy that helps them feel relaxed take it along to the photo session. It might help the child to remain calm while having their picture done. If your child insists on holding the toy ask the photographer to include it. If your child does not like to look directly at the camera have their picture taken while they are looking up.
5. Have a photographer come to the house if you do not feel comfortable taking the pictures. They can capture your Autistic child in their natural setting. This might make your child feel more relaxed. Consider taking the pictures outdoors.
6. If your child can not sit still for a picture allow them to stand, or lay down if they choose. Do not try to force them into a position they are uncomfortable with. This could lead to a meltdown. Allow them to direct the photo shoot. If the photographer does not want to cooperate find someone else that will.
7. Ask around. Find out where other parents have taken their Autistic children. They may know someone who has experience with special children.
8. Wear comfortable clothes for pictures. There are no rules that say every picture must feature your child in formal wear. Uncomfortable clothing can really bother an Autistic child with sensory issues.
9. Do not push so hard for a perfect picture. Pictures of children laughing and playing can be just as good as them sitting posed. If you keep pushing for a perfect picture you might upset the child to the point of getting no pictures.
10. Give the Autistic child time to warm up to the camera. Let them see how it works if they have not had their picture taken before. This can make them more relaxed and calm.
Try and make the experience as calm and relaxing as possible. This will allow your child to feel at ease. The pictures will turn out better by letting your child e themselves.
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