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Rare Surgery Ends 5-Year Silence - 2003-06-20

Last month, 26-year-old Amy Hancock went into the hospital for a 9-hour operation that was billed as the first of its kind in the United States. Five years ago, she'd lost her larynx and vocal chords to a rare form of cancer. To communicate, she had to use an electro-larynx, a small microphone-like device she held against her throat to create a mechanical sound.

The young woman and her doctor were both dissatisfied, they wanted other options. Three conventional surgeries all failed. Ms. Hancock's insurance company wouldn't cover a larynx transplant, so her doctor looked into using a surgical technique successfully performed in Germany. Prior to the surgery and using her electro-larynx Amy Hancock explained what he decided to do. "They're going to take a muscle from my arm and he's going to put it in my throat. And it's going to be sort of like a faux-larynx. It's not going to be a human sounding voice, it's not going to sound like yours. But it's going to be much better than this," she said.

And that's all she wants: something that helps her sound like the young woman she is. Her father, Ron Hancock, supported her quest. "You couldn't tell if it was a male or female with the electronic larynx. She was able to communicate but at the same time you couldn't tell who it really was," he said.

Five years ago, Amy Hancock seemed to have what it takes to succeed in the radio business: she was well on her way to finishing her communications degree at University of Missouri, St. Louis, she had a bubbly personality and a silky smooth voice, as you can hear from this recording, made when she worked at a country music station during college.

"Well if you said yes, that's terrific because right now we're talking to

Her doctor, Randal Paniello of Washington University in St. Louis, made sure his patient knew she'd never sound like that again. The makeshift speaking tube he created using skin tissue from her forearm and some cartilage from her nose would give her a breathy, raspy voice. She'd sound hoarse, but more natural. Dr. Paniello says the delicate surgery to give her a voice again took 9 hours. "Well it's microsurgery and to make the tissue survive when you transfer it you have to suture an artery and vein together to new vessels in the neck. It's done under a microscope and the sutures are smaller than a hair," he says.

The pseudo larynx or tube connects her wind- pipe with her swallowing passage or esophagus. Air passing through the tube vibrates the esophagus to create sound. "She does not have vocal chords per se. She has a way of getting air into her throat and that causes the throat tissues to vibrate. The vibration then becomes the source of the sound," he says.

After several weeks of healing, Amy Hancock got to try out her new voice for the first time on [June 16]. Her family nervously waited, along with the press, to hear what she would sound like. Her first words??

"I don't know what I should say first. I guess I should thank Dr. Paniello because he did it," she said.

That's Amy Hancock's new voice. As she beamed from behind the microphone, tears flowed down the faces of her parents, grandparents and sister. Even the nurses who had assisted Dr. Paniello crowded into the room, everyone wanted to hear what she'd sound like. Her mother, Mary Ann Pittman thought she sounded beautiful. "It was worth waiting for, it was definitely worth waiting for, the sky's the limit, she can do anything she wants to. She's so enthusiastic, she's up today and everything's going good. She can do anything or be anything she wants to be," she says.

Right now she needs to practice, that means lots of talking, and Dr. Paniello has given her the "all clear" to become a chatter box.

"It's going to get stronger. I just have to practice. It's only been an hour, so you have to give me a learning curve," she says.

High on her post-surgery agenda: replacing the electro-larynx with a cellular telephone. Since she had to hold the electronic device to her throat, she didn't have enough hands to talk on a phone and drive at the same time.