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In the world of laryngectomees, you will hear a number of terms used, often in different ways, so it is easy to become confused.

Let’s talk about some basic terms and their definitions.


Artificial Larynx (AL)
This is a new way of speaking. There are a number of AL types and some more information can be found at webwhispers.org/library/talking-again.asp.

Botox
An injection of Botulinum Toxin that is used to weaken a muscle that is too rigid or tight. The toxin weakens muscles by blocking the nerve impulse to the muscle and is not permanent.

Ear, Nose, Throat (ENT)
Otolaryngology (pronounced oh/toe/lair/in/goll/oh/jee) is the oldest medical specialty in the United States. Otolaryngologists are physicians trained in the medical and surgical management and treatment of patients with diseases and disorders of the ear, nose, throat (ENT), and related structures of the head and neck. They are commonly referred to as ENT physicians. www.entnet.org is the home page for the American Academy of Otolaryngology - Head and Neck Surgery.

Oesophageal Speech (ES)
A method of gulping and using air to be used for speech.

Hands-Free Valve (HF)
Adjustable Tracheostoma Valve, when used in conjunction with a voice prosthesis, allows hands free operation of the stoma, eliminating the need to use a finger or thumb to control the air passage. It enables hands-free, conversational speech. There are several ways of using a valve but the most common one is using a housing which is glued to the neck around the stoma. The valve fits into the housing and rests in an open position. A slight increase in pressure while exhaling causes the diaphragm to close and divert air through the prosthesis. At the completion of speech, the diaphragm automatically reopens as exhalation decreases.

International Association Of Laryngectomees (IAL)
The IAL (www.larynxlink.com) is a non-profit voluntary organization composed of member clubs and recognized regional organizations. Clubs, generally known as “Lost Chord” or “NuVoice” clubs, are composed of 10 laryngectomees or more. The purpose of the IAL is to assist these local member clubs in their efforts towards the total rehabilitation of the laryngectomee. www.webwhispers.org is an online club affiliated with the IAL.

Insufflation Test
A test given after laryngectomy and before TEP puncture to determine the voicing ability.

Irrigation
Squirting, spraying or dropping a small amount of saline solution or water in the stoma to moisturize the trachea and facilitate the removal of mucus.

Laryngectomee
A person who has had laryngectomy surgery.

Laryngectomy
A laryngectomy is surgical removal of the larynx, also called the voice box since it contains the vocal cords. It is located at the point where a division occurs from the single tube that makes up the throat (also called the pharynx) into separate tubes for food going to the stomach (the oesophagus) and air going to the lungs (trachea, or windpipe). The larynx is the organ in the throat that, through the use of the vocal cords, enables us to create speech. At the top of the larynx is the epiglottis. It is a valve, located at the top of the windpipe, that prevents food from entering the airway during swallowing.

Laryngoscopy
Examination of the larynx with a mirror (indirect laryngoscopy) or with a laryngoscope (direct laryngoscopy). The laryngoscope is a flexible, lighted tube used to look at the inside of the larynx (the voice box).

Larynx
Pronounced “Lair-rinks”, it is the portion of the respiratory tract containing the vocal cords. It is located between the pharynx and the trachea. Its outer wall of cartilage forms the area of the front of the neck referred to as the “Adams apple.” The vocal cords, two bands of muscle, form a “V” inside the larynx.

Lavage
Sometimes used with the same meaning as Irrigation.

Occlude
To block. In the case of laryngectomees with a TEP, manual occlusion is to block off the stoma (with finger or thumb) and change the path of the air being exhaled to go through the prosthesis. Hands Free occlusion is when you use your breath to make the Hands Free valve that fits over the stoma close and seal it off... just as your finger would do in manual occlusion.

Prosthesis
A voice prosthesis is a small removable silicone tube that connects the lungs and oesophagus by way of the TracheoEsophageal Puncture. It has a one way valve at the interior (esophageal) end which prevents liquids or foods from coming back into the trachea. When you cover (or occlude) the stoma, this redirects exhaled lung air through the prosthesis into your oesophagus. This airflow causes the upper part of the oesophagus to vibrate, and we use the sound this produces, modified by the tongue, teeth, and lips, to form sounds which make up words and speech.

Puncture
The opening which is surgically created between the trachea and oesophagus. See TEP.

Speech Language Pathologist (SLP)
A person trained to assist people with all types of speech difficulties and disabilities. There are SLPs who have no experience with laryngectomees, others who have special training and are proficient at helping people with AL, ES, or TEP speech. An SLP who is good at teaching someone one type of speech may not know much at all about another type of speech. Your doctor usually has an SLP that he works with or will refer to.

Squamous Cell Carcinoma (SCC)
Cancer that begins in squamous cells -- thin, flat cells that look under the microscope like fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts so squamous cell carcinomas may arise in any of these tissues. This is the most common type of larynx cancer.

Stent or Catheter
A catheter is a hollow rubber tube with a rounded end that comes in different sizes. A stent is usually tapered and solid. Either is used to hold the puncture open or to stretch it gently when changing to another prosthesis. The puncture will close in a remarkably short period of time if one of these is not used when the prosthesis is removed.

Stoma
Also known as a tracheostoma. It is the hole in the neck made by redirecting your trachea (windpipe) forward and creating a permanent opening. After the surgery, your air will move in and out of your lungs through the stoma instead of through your mouth, nose and throat.

Support Group
A group who meets to provide support for people who have similar problems. It may be run by a professional or by the participants. This may be a club that is part of a clinic or hospital and could be affiliated with the IAL or not. The main purpose it to share and learn from each other.

Tracheoesophageal Puncture (TEP)
A TEP is a surgically made passage between the trachea and oesophagus to hold a prosthesis. It enables lung air to pass through the prosthesis and be used to make speech again.

Vent
A button, tube or vent and is worn in the stoma. They come in all shapes and sizes. Curved or straight; long or short; different diameters and made of different materials. They sometimes have a place to tie a band around your neck to keep it in place and some have a ridge around the back edge to hold it in your stoma without a tie. They all have some kind of a flange or collar on the outside to keep them from slipping into the trachea. The main purposes are to keep your stoma nicely shaped and stretched out to the size they need to be for comfortable breathing.

Voice Institute (VI)
The International Association of Laryngectomees (IAL) Voice Institute offers a premier, intensive training course designed to familiarize Speech Pathologists (ST’s), laryngectomees with excellent speech rehabilitation (LT’s), laryngectomees desiring self improvement in communication skills who enroll as Voice Institute Pupils (VIPs), and other health professionals with state-of-the-art methods of alaryngeal speech restoration, and medical/surgical treatment for individuals with laryngeal cancer. Observations and selective hands-on experience with alaryngeal speech alternatives are unique features of the course.” The VI is held every year at the same time as the IAL Annual Meeting (AM).

Visit the IAL website at www.theial.com for current information.

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