I. Preoperative consultation

 A. Meet with both patient and spouse if possible
 B. Assess facts patient and spouse have about upcoming surgery and if necessary give additional information about the surgical procedure
 C. Discuss alternatives for postoperative communication
 D. Discuss physiological changes associated with functions such as laughing and coughing, impaired sense of taste and smell, inability to blow nose or sneeze, the stoma, mucus, feeding tube and swallowing problems and altered physical appearance
 E. Assess patient's speech intelligibility prior to surgery including such things as rate of speech dialect or accent, articulation errors, degree of mouth opening, etc.
 F. Assess patients cognitive level to determine capability for learning - if patient is illiterate arrange for communication board to be used for communication until artificial larynx is introduced
 G. Discuss services provided by SLP
 H. Arrange visit from another laryngectomee is possible
 

II. Postoperative consultation

 A. First visit
  1. Respond to questions of patient or family
  2. Supply reading material concerning common problems of laryngectomees
  3. Talk again about some of the changes the patient and family will face

 B. Second visit
  1. Discuss literature from first visit
  2. Orient patient to all three methods of alaryngeal speech (American Cancer Society film, Speech After Laryngectomy, 1988)

 C. Third and subsequent visits
  1. Demonstrate all artificial larynx devices and TEP voice prosthesis procedures when appropriate
  2. Begin instruction in use of an artificial larynx
  3. Recommend and when possible arrange for issue of an artificial larynx device
  4. Schedule patient as outpatient or arrange for outpatient services from other facility

Adapted from checklist created by Barbara Cady and Shirley Salmon, VA Hospital, Kansas City, Missouri