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Conditions For Speech Therapy: Laryngectomy

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.

Possible Problems

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.

Improving Talk Through Telemedicine - WABI
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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Speech Therapy Voice Training For The Laryngectomee

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.

Artificial Larynx

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.

Esophageal Speech

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.

Transesophageal Speech

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
More at Laryngectomy support group to meet Thursday - WKTV

Acupuncture and Autism

Studies have revealed that there is a rise in the amount of children which have been diagnosed with autism. Up to now, healthcare providers have not yet discovered a cure for this ailment which is why some parents want to experiment with alternative forms of therapy and a particular example of this can be acupuncture.

Acupuncture is a holistic method in treating and preventing some conditions. Its principal tool are incredibly thin needles which are introduced to targeted locations in the body. The body contains approximately 400 of these linked through a system known as meridians or pathways. As soon as these are stimulated, these are purported to create balance within the body.

Autism on the other hand is really a brain dysfunction that is long term. This disorder is characterised by shortfalls in language, social communication and cognition. Children who are diagnosed with this ailment may also are prone to resultant disorders such as aggression, irritability, stereotypes, hyperactivity, negativism, unstable feelings, temper tantrums, short attention span plus obsessive-compulsive behavior.

Preliminary research have shown that acupuncture may provide symptomatic relief to youngsters suffering from autism. Although difficult in the beginning, it is thought that it is rewarding in the long run. This is because while traditional therapy and treatment requires that the child keep still, acupuncture doesn’t. Many claim it’s a quick prick at the vital locations in the body.

A small group of children in the US participated in a trial to discover how effective acupuncture is among children. There are 22 respondents and each of them was given the therapy once every other day for four months.

After the treatment twenty out of the 22 respondents showed remarkable progress. In fact 2 of them have cerebral blood flow. The only thing that did not change prior to treatment and after appeared to be the blood flow between left and right cerebrum as it showed no variations.

Apart from traditional acupuncture to help youngsters with autism, a preliminary study in Hong Kong is trying to see if tongue acupuncture can produce more beneficial results.

Results have showed that of 30 respondents in the experiment, majority demonstrated useful enhancement of assorted degrees according to the age and severity of their disabilities. Some enhancement had been noticeable within a few TAC sessions, specifically for drooling, spasticity (scissoring or tiptoeing), ataxia, and poor stability in walking. Functional enhancement was spotted after one to two courses of TAC. Most children put up with TAC well, with only occasional pain and slight bleeding in certain patients.

The main reason why tongue acupuncture is being checked out is because there is a connection between the tongue and the heart through the meridians that spread to all the organs in the body. It is assumed that the points on the tongue can influence the state of the other body organs hence giving comfort for the one suffering from autism.

But many believe that acupuncture on its own can not help autism victims. It has to be coordinated with other things like maintaining a specific food plan to help improve one’s temperament and communication schools. Although it is only short term, it is better than little or nothing until a remedy is found.

When may the cure emerge? Only time can tell as there are many other questions that have to be answered to ensure that doctors to further comprehend neurological disabilities. Doctors who are conducting research think that an interdisciplinary approach is needed given that acupuncture has shown positive results in helping children with autism.

Self-Injury: How to Stop this Dangerous Practice

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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Autistic Children Need Schedules

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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