Answer to Question 1
Individuals who have undergone a laryngectomy (surgical removal of the larynx) face many problems and lifestyle changes as a result of this surgery. Clients must breathe through a tracheotomy, which is an opening in the trachea, created during a surgical procedure called a tracheostomy. Some of the problems that result from this procedure include the following:
Loss of phonation
Difficulty coughing and eliminating phlegm from the airway
Need to avoid swimming or any other activities that expose the stoma to water or pollutants
Need to give away house pets that shed hair, because hair can be caught in the person's unprotected airway
Difficulty enjoying the flavor of different foods, because the person cannot breathe through his or her nose
Dryness of the oral tissues due to salivary gland damage that occurs when radiation is required following surgery
Difficulty swallowing (dysphagia), which results from severe oral dryness
Risk of aspiration if food or fluids accidentally enter the stoma
Answer to Question 2
Speech-language pathologists (SLPs) are usually the first individuals to notice problems in a person's speech. It is very important for SLPs to refer a person for voice therapy if they suspect a voice dysfunction. The person with a hoarse voice may be abusing his or her phonatory mechanism. For example, individuals may become hoarse if they spend excessive time in noisy environments, where they must speak loudly to be heard. Also, the person could be developing vocal nodules or even early laryngeal cancer.
The person who has an increasingly weak voice or must exert a great deal of effort to speak should be referred to a neurologist. For instance, myasthenia gravis (a myoneural disease) is characterized by progressive weakness of phonation, progressive loss of the ability to articulate, and worsening hypernasality. This condition can be treated. Often the SLP is the first person to recognize myasthenia gravis and refers the individual to a health care specialist.
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