Klaske van Sluis

CHAPTER 9 General discussion The typical clinical trajectory for total laryngectomy patients is oriented to- wards curative treatment, restoring communication, and reducing functional issues patients have to cope with. In this thesis we investigated the multidimen- sional impact of this surgery by exploring voice and speech outcomes (section 1) and functional issues and well-being (section 2) following total laryngec- tomy. Within this discussion, the implications of the studies are discussed, and recommendations for further research and clinical practice are made. 9.1 Voice and speech outcomes 9.1.1 Summary of the findings Speech rehabilitation methods With the systematic literature review in Chapter 2 , we investigated the differ- ent types of speech rehabilitation methods after total laryngectomy and report objective and subjective outcome measures. For several decades detailed studies on voice outcomes have been published, investigating acoustic and perceptual outcomes. Most studies include small groups of participants and there is a dif- ference in offered speech rehabilitation methods. The earlier studies primarly show mostly outcomes on esophageal speech and electrolarynx speech, while more recent studies do evaluate tracheoesophageal speech. The studies included in this systematic literature review show that tra- cheoesophageal speech offers the most natural speech result after total laryngec-