have traditionally had four communicative alternatives. The
first and least intrusive is any form of nonverbal communication.
. . writing, gesture/pantomime, or communication boards. While
effective, these methods are quite time consuming, tiring,
and are only effective for face-to-face situations.
In addition, other difficulties may prohibit the use of the electrolarynx including:
fourth alternative had been Tracheoesophageal Puncture (TEP).
Cost of the surgical procedure to create the puncture averages
$ 2000 to $3000, not including pre- and post-operative visits,
medications, supplies (prosthesis, French Catheters, saline
solutions, etc.) and ensuing speech therapy. Total costs can
easily exceed $6000. Many patients have successfully undergone
this procedure since its inception. Perhaps the greatest asset
of TEP is the tremendous volume that some patients are able
to achieve. Clarity is also judged to be good to excellent,
depending on the patient.
Contraindications to TEP include:
addition, the success of the TEP can be hindered by a patient's
failure to properly care for the prosthesis, improper fitting
of the prosthesis with subsequent air leakage and fungi build
up. It is not uncommon for a patient to drop the prosthesis
into the trachea or lung creating a traumatic and painful
situation for the patient until it is removed by a doctor.
Unfortunately about four people in ten (40%) are not successful
with the T.E.P. long term. This additional surgery with a
relatively low success rate can also lead to longer problems
such as infection and fistula as well as requiring admission
to the emergency room when voice proteses fall into the lung.
As a result many laryngectomees opt not to undergo this treatment.
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