- 著者
- 
             
             Asako Kaneoka
             
             Rumi Ueha
             
             Miki Nagatomo
             
             Akiko Matsunaga
             
             Shigeko Umezaki
             
             Haruhi Inokuchi
             
             Toru Ogata
             
          
- 出版者
- The Japanese Association of Rehabilitation Medicine
- 雑誌
- Progress in Rehabilitation Medicine (ISSN:24321354)
- 巻号頁・発行日
- vol.7, pp.20220064, 2022 (Released:2022-12-23)
- 参考文献数
- 27
- 被引用文献数
- 
             
             
             1
             
             
          
        
        Background: To prevent aspiration, patients with irreversible dysphagia may          undergo surgeries that separate the esophagus and trachea. Such interventions result in          loss of vocal function and require alternative communication methods. We report a patient          with amyotrophic lateral sclerosis (ALS) who used esophageal speech after receiving a          central-part laryngectomy (CPL) to prevent aspiration.Case: A 64-year-old woman with ALS was admitted to our hospital. The patient          maintained good cognitive and oral function and presented with mild dysarthria and          dysphagia. Faced with rapidly worsening respiratory distress, saliva aspiration, and          excessive sputum, she underwent a tracheostomy on the premise of invasive ventilation.          Subsequently, the patient began using a voice-generating application for communication.          Given the patient’s sincere hope to prevent aspiration and aspiration pneumonia, achieve          safe oral intake, and decrease caregiver burden for frequent suctioning, the patient          underwent a CPL. Following surgery, belching was observed during meals, and the patient          could phonate when she belched. This finding led to four speech therapy sessions to          practice esophageal speech, allowing the patient to use the pseudo-speech technique for          short conversations. Removal of the entire cricoid cartilage in the CPL decreases the          upper esophageal sphincter (UES) pressure, thereby allowing air to easily pass through the          UES. Therefore, the patient could use the air as a sound source for esophageal speech          without extensive training.Discussion: Esophageal speech may be an alternative to oral communication in          patients undergoing CPL. Further research is warranted to generalize these findings to          patients undergoing CPL.