The different types of therapy: where? when? how?
On discharge from the hospital, your patient has the choice between several places where he/she can be treated:
– He/she can start his vocal rehabilitation with the speech pathologist of the ENT department where he/she was operated as an outpatient. The sessions usually take place on average two or three times per week, in small groups of different levels or individually.
He/she can start a therapy with a private practice speech pathologist.
– He/she can join a specialised re-education centre with intensive residential courses. The management is global: physical therapist, dietician, medical monitoring, radiation therapy, etc.
The actual vocal rehabilitation (learning a substitution voice) may start once the healing is complete and requires medical prescription. However, it is essential to start the speech therapy before the post-operative radiation therapy. In fact, it is easier to acquire the voice at that time because the muscles have not yet been hardened by the radiation therapy.
Learning the oro-oesophageal or tracheosophageal voice is possible:
– at D10, post-operative, when the patient underwent a primary laryngectomy,
– at D21, post-operative, when the patient underwent a post-X-ray laryngectomy
In all cases, you must always have the written prescription of the surgeon.