This study aimed to evaluate rate of the COVID-19 disease, its severity, mortality rate and anxiety levels in subjects who underwent total laryngectomy.

The subjects who underwent total laryngectomy were included in the study. The data were first obtained retrospectively and then a telephone survey was applied. Anxiety levels was evaluated by the Coronavirus Anxiety Scale (CAS).

A total of 54 subjects were included in the study. Nine (16.7%) males were reported to be infected with SARS-CoV-2. Five (55%) of them were hospitalized; 2 of them (22%) were taken to intensive care units, and one subject (11%) died. Although a tendency to increase risk of COVID-19 disease in the tracheoesophageal voice prosthesis users (23.1% vs 14.63%) was observed, statistically difference was not significant. The average total CAS score was significantly higher in those who had COVID-19.

The data documented that people who underwent total laryngectomy developed more frequent and more severe COVID-19 disease and had a higher mortality rate. Although no obvious variable was found, our data suggest that using a tracheoesophageal voice prosthesis may be somewhat effective. Besides, our subjects presented very low anxiety about COVID-19.

Tracheoesophageal puncture represents the ‘gold standard’ for voice restoration following laryngectomy. Tracheoesophageal puncture can be undertaken primarily during laryngectomy or in a separate secondary procedure. There is no current consensus on which approach is superior. The current evidence comparing primary and secondary tracheoesophageal puncture was assessed.

A systematic review and meta-analysis of articles comparing outcomes for primary and secondary tracheoesophageal puncture after laryngectomy were conducted. Outcome measures were: voice success, overall complication rate and pharyngocutaneous fistula rate.

Eleven case series met the inclusion criteria, two prospective and nine retrospective. Meta-analysis did not demonstrate statistically significant differences in overall complication rate or voice outcomes, though it suggested a significantly increased risk of pharyngocutaneous fistula in primary compared to secondary tracheoesophageal puncture.

Primary tracheoesophageal puncture is a safe and efficient approach for voice rehabilitation. However, secondary tracheoesophageal puncture should be preferred where there is a higher risk of pharyngocutaneous fistula.

Functional voice rehabilitation is becoming increasingly important following total laryngectomy and pharyngolaryngectomy. Tracheoesophageal voice via a shunt valve is currently regarded as the ‘gold standard’ for voice rehabilitation. Traditional techniques usually allow for the replacement of valves in the out-patient setting; however, patient factors such as altered anatomy may occasionally prevent this.

This paper describes a novel approach for speech valve insertion that is safe, quick and cost-effective, and which uses equipment commonly available in ENT wards and the operating theatre.

A multidisciplinary team approach is required for the preservation of voice and appropriate management of glottic cancer. This study aimed to investigate the outcomes of surgically treated glottic cancers of all stages. All aspects of surgical management, such as laser cordectomy, partial laryngectomy, total laryngectomy with voice prosthesis, and salvage laryngectomy, conducted at a single tertiary care institute in India, were reviewed.

A retrospective analysis of hospital records was performed for 192 glottic cancer patients who were surgically treated between 2003 and 2007.

Patients with tumour stages 1 or 2 glottic cancer treated with laser cordectomy had a local control rate of 85 per cent and five-year survival rate of 98.6 per cent. The findings suggest that the number of partial laryngectomies performed for stage 3 tumours is declining. Patients with a tumour stage 3 lesion with a fixed hemilarynx or a tumour stage 4 lesion, treated with total laryngectomy, were found to have a five-year survival rate of 61.6 per cent. Nodal status was significantly associated with five-year survival rate.

Surgery offers a viable five-year survival rate in glottic cancer patients.

To demonstrate a simple, practical, cheap method of preventing potentially fatal aspiration of a dislodged voice prosthesis; this method was developed by a laryngectomised patient.

A patient diagnosed with squamous cell carcinoma of the larynx underwent total laryngectomy. Upon completion of radiotherapy, a tracheoesophageal fistula was created and a voice prosthesis inserted to enable voice restoration. Unfortunately, the patient presented subsequently with repeated episodes of dislodgement and an episode of potentially fatal aspiration of the voice prosthesis, despite various measures taken by the surgeons to overcome the problem. The patient subsequently developed a method enabling him to retrieve the voice prosthesis himself should it become dislodged. He attached a ring to the prosthesis, which was larger in diameter than the tracheal stoma, thus preventing ingestion or recurrence of aspiration.

To our knowledge, this is the first report in the world literature of this form of innovation, created by a laryngectomised patient, to overcome the problem of aspiration or ingestion of a dislodged voice prosthesis.