Woman regains ability to speak after larynx surgery

Tuesday, June 17, 2003

ST. LOUIS -- Amy Hancock's first words were thank you.

Hancock discovered Monday that she can speak again, after surgery last month to restore a voice she hasn't had since losing her larynx to cancer five years ago.

The operation, in which doctors made a patch of skin into a breathing tube, was the first of its kind in the United States.

"I don't know what I should say first," Hancock, 26, told a roomful of family members, medical staff and reporters gathered at the Barnes-Jewish Hospital Center for Advanced Medicine.

The first words she uttered during her examination Monday were "thank you, thank you, thank you" to the surgeon who performed the operation.

Hancock's voice was low and raspy, but her words were clear.

"It's worth everything now, all the staples and surgeries." She said she expects to make a lot of phone calls.

Dr. Randal Paniello said Hancock's voice quality was as he expected. He explained that she still has no vocal cords, and will not make clear, continuous sound. But she can speak as often as she wants and, with work, should improve to where her voice will sound hoarse.

Before, Hancock had to use an electrolarynx, a device that produced vibrations, to speak. She said she wanted to try an alternative because she was so young and no one could tell if she was a man or a woman when she spoke.

And, she added, she'll now have her hands free to gesture when she talks.

'She had a beautiful voice'

Hancock's family members beamed as she spoke, and her mother and grandmother had tears in their eyes. Hancock's mother said she couldn't wait to have conversation with her daughter.

"Anything she wants to talk about, I'm willing to listen," said Mary Anne Pittman. "She had a beautiful voice, it just flowed out of her like it was meant to be, and it will again."

Hancock, a one-time country music disc jockey from Flora, Ill., said she wasn't sure what the future holds.

"I'm just happy that it worked. I'm happy we could help somebody," said Paniello, a head and neck surgeon at the Washington University School of Medicine.

During the surgery May 23, he removed a patch of skin from Hancock's left arm and made it into a tube. He also took an artery and vein to feed the flap of skin.

The doctor fashioned the 2-inch-by-2-inch patch of skin into a breathing tube and inserted it into Hancock's trachea, which was turned to allow her to breathe through a hole in her throat. Paniello made an incision in the trachea, and inserted the skin tube to reconnect Hancock's trachea and esophagus.

He used cartilage from Hancock's nose make the flap at the end of the tube stiff. The tube was positioned so that food or drinks traveling down the esophagus to the stomach push the flap down to cover the tube.

The surgery had never been performed in the United States, but has been successfully performed in Germany.

Hancock breathes through the hole in her throat. She uses her thumb to block the open trachea to talk, forcing air through the tube into the oral cavity.

She'll have another procedure to have a valve placed there, which should mean she won't need to use her thumb to block the hole to speak.

When asked if Hancock will ever be able to sing, Paniello said, "She has my blessing to try."

"I thought we were going to karaoke," she joked with her doctor.

"You first," he responded.

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