Table 3.

Areas of focus in SLP interventions.

Pre-surgery phase
Goals	Solve all doubts that may arise to the patient and their relatives, related to what their life will be like, from the anatomical, physiological and functional point of view, after TL.
	Provide information regarding potential sequelae, such as vocal, pulmonary, eating and olfaction sequelaes. Information about their treatment and the existing devices to reduce the impact and preserve their quality of life, such as cannulas, adhesives, free hands devices for speech among others.
	Explain and show communication alternatives available.
	Promote contact with another person who has already been rehabilitated or, when appropriate, provide audiovisual materials with real examples of similar cases of patients that satisfactorily overcome their illness and rehabilitation process.
	Evaluation of vocal rehabilitation possibilities of the patient.
	Evaluate phonatory, respiratory, swallowing and olfactory patterns, to adjust an adequate prophylactic program if necessary, and determine realistic goals for rehabilitation according to the needs, expectations and commitment of the patient.
	Design a prophylactic program of pre-surgical exercises, according to time, treatment, and patient feasibility.
	Structure the therapeutic work plan after surgery, agreed between the patient and their SLP.
Post-surgery phase
Goals	Fitting the proper system to help the patient for communication during hospitalization.
	Global evaluation to determine how is the starting point for rehabilitation, in terms of mood, communicative intention, scarring, fistulas, nasogastric tube, dysphagia, skin condition, configuration of the stoma, volume and characteristics of the secretions, voice prosthesis, weight, muscle tone…
	First adaptation of the rehabilitation devices.
	Review and start of the therapeutic work plan established in the pre-operative evaluation.
Follow-up phase
Goals	Permanent review of concepts and doubts that the patient and or family may have.
	Prevention of difficulties associated with the use of rehabilitation devices through training in the proper use of it, and the understanding of the warning signs that the patient should inform to the professional.
	Promotion of patients' self-care regarding rehabilitation and management of the rehabilitation devices.
	Checking of the evolution of the established therapeutic goals.
	Upon discharge, providing the patient with an easily accessible SLP contact.

Intervention of the expert SLP on main sequelae groups: voice, pulmonary, eating and olfaction. TL, total laryngectomy; SLP, speech and language pathologist'.