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Biomedical subjects

R W Welch

Publications and source records attributed to R W Welch.

38 records · Page 3Linked to original sources

Current status of laryngectomee rehabilitation: I. Results of therapy.

Of 103 people with the clinical diagnosis of laryngeal cancer studied by the authors, 53 eventually were treated by total laryngectomy and, in some cases, radical neck dissection (43), preoperative radiation therapy (15), postoperative radiation therapy (29), and post-operative chemotherapy (7). All were entered into a comprehensive rehabilitation program. Six months following completion of their cancer therapy 47 were re-evaluated. Of these, 12 (26 per cent) used esophageal speech as the dominant mode of communication, 16 (34 per cent) the electrolarynx, and the remainder either wrote (16 [34 per cent]) or signed (3 [6 per cent]). Twenty-six (55 per cen) were considered to be successfully) rehabilitated overall and 21 (45 per cent) were not. These data indicate that the rehabilitative needs of today's laryngectomee are not being met successfully with traditional methods.

Adult↗

Change in the force-summed pressure measurements of the upper esophageal sphincter prelaryngectomy and postlaryngectomy.

The pharyngoesophageal high pressure zone (PE-HPZ) was measured prelaryngectomy and postlaryngectomy with a new force-summing probe that accounts for sphincter pressure asymmetry. A total of 31 patients were studied six times each. Postoperatively, pressures dropped from 130+/-24 mm Hg to 66+/-9 mm Hg. After a standardized, intensive laryngectomy rehabilitation program, 12 of 19 postoperative patients acquired acceptable esophageal speech and 7 did not. Speakers and nonspeakers were found to have nearly identical PE-HPZ pressures (speakers = 70+/-10 mm Hg, nonspeakers = 59+/-18 mm Hg). Differences in sphincter length or relaxation likewise did not discriminate between these two groups. We conclude that PE-HPZ pressure is not a critical determinant of the acquisition of esophageal speech.

Aged↗