Voice Refinement Following Conservation Surgery for Cancer of the Larynx

This paper addresses the effects of conservation laryngectomy, the outcome of voice quality, and a rationale for voice treatment. Conservation or partial laryngectomy surgical procedures seek to remove malignant tissue but also preserve some laryngeal structures, particularly when larger tumors exist. These procedures attempt to maintain both sphincteric and phonatory function of the postoperative larynx. The extent of surgical resection does not always correlate well with a patient's postoperative voice outcome. Thus, preconceived notions of postsurgical vocal function are often problematic. This tutorial discusses: (a) the rationale underlying the use of conservation laryngectomy procedures, (b) the clinical identification of the anatomical and subsequent physiologic basis of voice change following conservation laryngectomy, (c) the potential for functional compensation by the patient following conservation surgery, and (d) a rationale for voice refinement using treatment methods that traditionally have been employed for benign forms of laryngeal pathophysiology.