Total laryngectomy (TL) as an operation has evolved since it was first performed by Billroth in 1873, and has declined in use as the primary treatment for advanced laryngeal cancer. This decline in use has been arguably associated with a decline in survival rates. Less controversial is the critical requirement to provide alaryngeal patients with acceptable forms of voice restoration, which include electrolarynx, esophageal speech, and indwelling tracheoesophageal prostheses (TEP). Of these, the use of TEP has been shown to significantly improve patient quality of life, self-esteem, and sexual function with concomitant decrease in symptoms of depression and anxiety. Objective assessments of voice restoration outcomes, including TEP device life, are necessary to properly counsel patients and engage in shared decision making about voice restoration after laryngectomy.
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