Voice rehabilitation after total laryngectomy in West Germany. Current state of the art

In 1987 Lopez published the results of a survey of voice rehabilitation after total laryngectomy as carried out by 400 North American ENT surgeons. In order to obtain the same information on the current state of voice rehabilitation in the German Federal Republic we did a similar survey of 103 ENT clinics. Ninety-five (92%) questionnaires were evaluated. Each year, 2200 laryngectomies are carried out in Germany. Oesophageal speech is the most frequently used form of voice rehabilitation in both countries. In the USA voice prostheses are fitted by 88% of the surgeons questioned to a total of 30% of patients; in Germany only 22% of the clinics in which laryngectomy is carried out fit these devices to a total of 5.6% of patients. External vibrators are used with equal frequency (28%). In contrast to the United States, where intraoral aids are currently used in 15% of patients, we do not employ these at the present time at all. Voice shunt operations (Staffieri, Asai, Amatsu etc.) are still carried out in 7 clinics (6.7%) on 0.7% of all patients (USA: 16% of surgeons on 15% of patients). In the United States 9% of patients are not rehabilitated compared with 6.7% in the Federal Republic.