A proposed model of speech therapy care for patients after short-term intubation accompanying thoracic and endocrine surgery procedures

Abstract

Patients experiencing surgical procedures under general anesthesia undergo an intubation procedure enabling mechanical ventilation. Depending on the type of procedure performed, the anesthesiologist performs endotracheal or endobronchial intubation. Short-term intubation affects voice quality changes in a certain time interval after extubation and sometimes leads to long-term anatomical and functional disorders. Therefore, patients hospitalized due to surgical procedures should be provided with adequate speech therapy care during the convalescence period. The main objective of this study was to create a proposal for speech therapy support for patients after thoracic surgery and endocrine surgery based on clinical experience gained during clinical trials at the Pulmonology and Thoracic Surgery Center in Bystra with the participation of 14 patients undergoing thoracic surgery and 12 patients undergoing thyroid surgery. In order to verify the hypothesis that it is necessary to implement speech therapy support for patients undergoing procedures under general anesthesia with intubation, theoretical, experimental and observational methods were used during clinical trials. The proposed therapeutic interventions should be aimed at eliminating the effects of short-term intubation, such as hoarseness, dysphonia, dysarthria, dysglossia, velopharyngeal insufficiency or palate paresis. The work of a speech therapist should be based on improving breathing, phonation, and in justified cases also articulation and, what is particularly important, respiratory‑phonatory coordination. The proposed interventions presented in the paper should be a starting point for further clinical studies aimed at creating a comprehensive standard of speech therapy treatment for patients undergoing surgery under general anesthesia with accompanying short-term intubation, with particular emphasis on patients of thoracic surgery and endocrine surgery departments.