Comprehensive strategies for respiratory and communication rehabilitation in patients with post-laryngectomy syndrome: a review of current rehabilitation programs and medical-social assessment



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Abstract

Total laryngectomy is a radical surgical procedure that results in permanent anatomical and physiological changes. It is performed annually on thousands of patients with advanced laryngeal cancer. Its consequences extend far beyond voice loss: postlaryngectomy syndrome encompasses respiratory dysfunction, anosmia, dysphagia, profound psychosocial distress, and persistent disability. Despite the significant expansion of rehabilitation methods in recent decades, a comprehensive assessment of their evidence base in conjunction with the challenges of medical and social assessment has not been conducted in the Russian literature. This review covers publications from 2015–2026 from the PubMed, Scopus, CyberLeninka, and eLIBRARY.ru databases. Modern approaches to respiratory function restoration using heat and moisture exchangers and expiratory muscle training are examined; significant improvements are demonstrated to be achieved within the first two weeks of systematic device use. Three voice rehabilitation methods-tracheoesophageal bypass, esophageal speech, and electrolarynx-are analyzed, assessing their acoustic characteristics, complications, and predictors of success. The colonization of voice prostheses, the role of the oropharyngeal microbiota in its formation, and the prospects for microbiome-focused prevention are discussed separately. The section on olfactory rehabilitation reveals a fundamental paradox: the highly effective and equipment-free NAIM maneuver is practically not integrated into standard patient management protocols. The psychosocial component is viewed not as optional, but as predictive of functional outcomes. The potential of remote rehabilitation formats, as well as the organizational conditions for their implementation in the Russian context, are discussed. We presented a structured understanding of why rehabilitation of a laryngectomized patient cannot be reduced to the choice of a voice replacement method, and a specific justification for how the medical and social examination procedure should be reoriented from recording the anatomical defect to assessing functional recovery using ICF instruments and validated scales.

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About the authors

Airat R. Galimov

Bashkir State Medical University, Ufa

Email: airat.galim382@gmail.com
ORCID iD: 0000-0003-4403-0204
SPIN-code: 8742-4109
Scopus Author ID: 294101

cand. med. sci., associate professor; neurologist, forensic medical expert

Russian Federation, Ufa, Russia

Dinara E. Saitova

Bashkir State Medical University, Ufa

Email: Lady.sai@icloud.com
ORCID iD: 0009-0008-1962-3394
Russian Federation, Ufa, Russia

Zaira M. Kappusheva

North Caucasus State Academy, Cherkessk

Email: Zaira.kappusheva11@mail.ru
ORCID iD: 0009-0000-7530-5149
Russian Federation, Cherkessk, Russia

Edgar A. Shaev

North Caucasus State Academy, Cherkessk

Email: theedgarhd@mail.ru
ORCID iD: 0009-0006-1160-6069
Russian Federation, Cherkessk, Russia

Magomed M. Saidgasanov

Rostov State Medical University, Rostov-on-Don

Email: saidgasanov03@gmail.com
ORCID iD: 0009-0006-7636-6094
Russian Federation, Rostov-on-Don, Russia

Klim R. Bozhinskiy

Rostov State Medical University, Rostov-on-Don

Email: maik-07.01@bk.ru
ORCID iD: 0009-0004-1628-6290
Russian Federation, Rostov-on-Don, Russia

Vladislav Yu. Pshenichnyi

Rostov State Medical University, Rostov-on-Don

Email: efimova-01@mail.ru
ORCID iD: 0009-0002-5914-946X
Russian Federation, Rostov-on-Don, Russia

Feride I. Ramasanova

Rostov State Medical University, Rostov-on-Don

Email: faridkaramazanova@gmail.com
ORCID iD: 0009-0000-2913-3892
Russian Federation, Rostov-on-Don, Russia

Kamilla Yu. Savelenko

Rostov State Medical University, Rostov-on-Don

Email: mamilla.savelenko@gmail.com
ORCID iD: 0009-0000-3703-3031
Russian Federation, Rostov-on-Don, Russia

Taulan N. Chotchaev

North Caucasus State Academy, Cherkessk

Email: taulanchotchaev3@gmail.com
ORCID iD: 0009-0003-9618-9935
Russian Federation, Cherkessk, Russia

Liliana A. Kuzheva

North Caucasus State Academy, Cherkessk

Email: liliana.kuzheva000@mail.ru
ORCID iD: 0009-0004-0757-7184
Russian Federation, Cherkessk, Russia

Irina S. Kashlaeva

Детская городская поликлиника № 1, Ростов-на-Дону

Author for correspondence.
Email: irina.kashlaeva@mail.ru
ORCID iD: 0009-0000-5094-2520
Russian Federation, Rostov-on-Don, Russia

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Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 86505 от 11.12.2023 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80654 от 15.03.2021 г.