Find your voice again
When Goregaon resident Vikas Athavale, 51, lost his voice to laryngeal cancer (cancer of the voice box) last year, he also lost the hope of restoring it.
But the latest type of voice prosthesis fitted in his throat at Tata Memorial Hospital, Parel, last month has brought back that hope.
“For the last two years, I had difficulty breathing and my fading voice quality made life miserable. My business was badly hit due to my inability to speak. It was a depressing period for me and my family,” said Athavale, who runs a web designing and software development company.
Athavale underwent a procedure called laryngectomy, in which doctors replaced his diseased voice box with an indwelling prosthesis, which does not require to be removed for cleaning. Athavale is now taking lessons in how to use his voice prosthesis at the hospital’s speech and rehabilitation centre. “I am confident that I will be able to speak normally again,” he said.
Dr DA Chaukar, associate professor and surgeon at Tata Memorial Hospital, who operated on Athavale, said the hospital handles 150 to 170 such cases every year.
“The use of this form of voice rehabilitation is very safe and is now considered to be the gold standard among the available methods of voice rehabilitation,” Dr Chaukar said.
According to doctors, due to improvements in chemotherapy and radiation, at least 60 % of the patients with advanced laryngeal cancer are able to preserve the voice box.
In cases where these forms of treatment do not work, usually in patients who are in stage four (advanced stage) of laryngeal cancer, voice prosthesis can help restore the voice.
“The ideal patients for voice prosthesis are those who have good motivation, are mentally stable, have no alcohol or substance dependence, and have adequate visual acuity and normal lung function,” said Dr AK D’cruz, director, professor and surgeon, head and neck services, Tata Memorial Hospital.
Voice prosthesis has evolved a great deal in the past decade in terms of design and cost effectiveness, doctors said.
For instance, there is a low-pressure voice prosthesis, introduced recently, for effortless speech. The life span of the prosthesis is affected by the bacterial and fungal growth on it. To combat this, voice prosthesis coated with anti-microbial agents such as silver oxide and nystatin have also been developed.
“We now have voice prosthesis with a special magnetic component to prevent valve-related leakage problems. Recently, a hands-free voice prosthesis and heat and moisture exchanger has been introduced to make this device more user friendly. The moisture exchanger moisturises the inhaled air and the patient doesn't have to use his hand to use the prosthesis,” said Dr D’cruz.
Tata Memorial Hospital has started conducting annual workshops on voice rehabilitation where patients, who are having problems with their voice prosthesis, can replace the prosthesis free of cost.