1
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Azar SS, Shires CB, Dewan K, Chhetri DK. Total tracheoesophageal puncture failure: A scoping review of patient characteristics and etiologies. Head Neck 2024. [PMID: 39077940 DOI: 10.1002/hed.27901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 07/15/2024] [Accepted: 07/20/2024] [Indexed: 07/31/2024] Open
Abstract
OBJECTIVES Tracheoesophageal prosthesis (TEP) is a common method for post-laryngectomy speech rehabilitation. Despite its common use, some patients ultimately fail TEP rehabilitation. TEP dysfunction negatively affects quality of life due to poor voice quality and need for repeated interventions to restore TEP function. Occasionally, voice rehabilitation with TEP is completely unsuccessful. We performed a scoping review to characterize the main reasons for total TEP failure, in hopes of guiding selection of optimal TEP candidates. STUDY DESIGN Scoping review using PubMed of all English language articles from 1990 to 2020 addressing causes of TEP failure. METHODS This scoping review followed the population, intervention, comparison, outcome and study (PICOS) guidelines. Total TEP failure was defined as complete loss or abandonment of TEP voice or tract. A comprehensive search strategy using PubMed's MeSH subject headings and keywords was created. Causes and rates of failure were reviewed. RESULTS Among 544 peer-reviewed journal articles reviewed for inclusion. Seventy articles met inclusion criteria, resulting in a total of 4928 TEP voice restoration patients for analysis. 15.2% of these patients had total TEP failure. The most common reasons for failure were dissatisfaction with voice (26.3%), leakage (17.9%), inadequate patient motivation (14.7%), comorbidities (14.2%), stoma problems (11.6%), and abandonment of TEP after dislodgement (10.6%). CONCLUSION Common reasons for TEP failure included voice dissatisfaction, leakage, lack of patient motivation, patient comorbidities, and stoma problems. These factors should be considered when selecting candidates for TEP voice restoration.
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Affiliation(s)
- Shaghauyegh S Azar
- Department of Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA
| | | | - Karuna Dewan
- Department of Otolaryngology - Head and Neck Surgery, Louisiana State University, Shreveport, Louisiana, USA
| | - Dinesh K Chhetri
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
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2
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Sparks F, Coffey M, Dipper L, Morgan S, Hilari K. Tracheoesophageal Voice Therapy in Postlaryngectomy Rehabilitation: A Systematic Review. J Voice 2023:S0892-1997(23)00355-7. [PMID: 38000962 DOI: 10.1016/j.jvoice.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Following total laryngectomy, surgical voice restoration is considered the optimal modality for re-establishing communication via tracheoesophageal voice. Yet beyond the insertion of a voice prosthesis to elicit voice production, there is suboptimal clinical knowledge of how to rehabilitate the perceptual quality of tracheoesophageal voice. This systematic review will identify and critically evaluate the quality and effectiveness of therapeutic interventions for tracheoesophageal voice. The findings of this review will inform the development of a novel tracheoesophageal voice therapy intervention. STUDY DESIGN Systematic literature review carried out in accordance with PRISMA guidelines. METHODS The review protocol was registered with PROSPERO. Eight electronic databases were searched using a prespecified search strategy. Records were independently screened by two reviewers against inclusion and exclusion criteria. Eligible studies were assessed for quality using the PEDro, ROBIN-T, and NHLBI critical appraisal tools. Data was extracted pertaining to participant characteristics and the content, dosage, intensity and outcomes of interventions. RESULTS 6344 records were identified, of which 38 were included for full-text review. Six studies met the eligibility criteria for inclusion. Voice rehabilitation was not the primary focus in the majority of studies, and the risk of bias was identified across studies. There was significant heterogeneity in the interventions and outcome measures used within studies with insufficient detail provided on intervention content for tracheoesophageal voice. Evidence for the effectiveness of interventions was limited and inconsistent across studies. CONCLUSIONS This review found that tracheoesophageal voice therapy is an under-researched area of clinical practice. Evidence from the small body of existing studies was not sufficiently robust to inform clinical practice at this time. This review highlights the necessity to develop and test interventions aimed at improving the perceptual quality of tracheoesophageal voice.
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Affiliation(s)
- Freya Sparks
- Department of Language and Communication Sciences, City, University of London, London, United Kingdom; Speech and Language Therapy Department. Barts Health NHS Trust, London, United Kingdom.
| | - Margaret Coffey
- Speech and Language Therapy Department. Imperial College Academic Health Science Centre, London, United Kingdom
| | - Lucy Dipper
- Department of Language and Communication Sciences, City, University of London, London, United Kingdom
| | - Sally Morgan
- Department of Language and Communication Sciences, City, University of London, London, United Kingdom
| | - Katerina Hilari
- Department of Language and Communication Sciences, City, University of London, London, United Kingdom
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3
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Vojtech JM, Mitchell CL, Raiff L, Kline JC, De Luca G. Prediction of Voice Fundamental Frequency and Intensity from Surface Electromyographic Signals of the Face and Neck. VIBRATION 2022; 5:692-710. [PMID: 36299552 PMCID: PMC9592063 DOI: 10.3390/vibration5040041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Silent speech interfaces (SSIs) enable speech recognition and synthesis in the absence of an acoustic signal. Yet, the archetypal SSI fails to convey the expressive attributes of prosody such as pitch and loudness, leading to lexical ambiguities. The aim of this study was to determine the efficacy of using surface electromyography (sEMG) as an approach for predicting continuous acoustic estimates of prosody. Ten participants performed a series of vocal tasks including sustained vowels, phrases, and monologues while acoustic data was recorded simultaneously with sEMG activity from muscles of the face and neck. A battery of time-, frequency-, and cepstral-domain features extracted from the sEMG signals were used to train deep regression neural networks to predict fundamental frequency and intensity contours from the acoustic signals. We achieved an average accuracy of 0.01 ST and precision of 0.56 ST for the estimation of fundamental frequency, and an average accuracy of 0.21 dB SPL and precision of 3.25 dB SPL for the estimation of intensity. This work highlights the importance of using sEMG as an alternative means of detecting prosody and shows promise for improving SSIs in future development.
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Affiliation(s)
| | | | - Laura Raiff
- Delsys, Inc., Natick, MA 01760, USA
- Altec, Inc., Natick, MA 01760, USA
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
| | - Joshua C. Kline
- Delsys, Inc., Natick, MA 01760, USA
- Altec, Inc., Natick, MA 01760, USA
| | - Gianluca De Luca
- Delsys, Inc., Natick, MA 01760, USA
- Altec, Inc., Natick, MA 01760, USA
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4
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赵 小, 马 志, 李 碧, 冯 勇, 余 晓, 樊 建, 何 刚, 李 彬. [The one-stage technology of epiglottis function and voice reconstruction after total laryngectomy with the sternohyoid myocutaneous flap]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:753-757. [PMID: 36217653 PMCID: PMC10128554 DOI: 10.13201/j.issn.2096-7993.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Indexed: 06/16/2023]
Abstract
Objective:To investigate the clinical effect of one-stage sternohyoid musculocutaneous flap after total laryngectomy for reconstruction of epiglottis function and vocalization. Methods:A retrospective analysis of 8 patients who underwent total laryngectomy from November 2019 to September 2020. The sternohyoid myocutaneous flap was designed after total laryngectomy. The lower edge of the flap was sewed with the posterior upper edge of the tracheostomy opening, and the lateral and medial edges of the flap were anastomosed to create a vocal tube. The lateral edge of the upper end of tube was sutured with the anterolateral wall of the hypopharynx, then made full use of residual epiglottis and tongue root tissue to reconstruct epiglottis function. Results:None of the 8 patients had serious complications after total laryngectomies. Fifteen months after operation,the vocal tube flaps survived and had intact structure under fiberoptic laryngoscope. All patients could speak clearly and forcefully, and the swallowing function was intact. Conclusion:The use of adjacent myocutaneous flap to construct the vocal canal and reconstruct the epiglottis function is a simple and effective technique that can be completed in one stage and improve the voicing of patients undergoing total laryngectomy.
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Affiliation(s)
- 小龙 赵
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都,610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 志跃 马
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都,610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 碧澜 李
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都,610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 勇 冯
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都,610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 晓旭 余
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都,610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 建刚 樊
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都,610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 刚 何
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都,610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
| | - 彬 李
- />四川省人民医院 电子科技大学附属医院耳鼻咽喉头颈外科(成都,610000)Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology, Chengdu, 610000, China
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5
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Longobardi Y, Savoia V, Parrilla C, Marchese MR, Morra L, Mari G, Degni E, D’Alatri L. Pre-operative speech-language pathology counselling in patients undergoing total laryngectomy: A pilot randomized clinical trial. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01932-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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6
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Batista EKL, Soares JFR, Alves GADS, Pessoa LSDF, Andrade WTLD, Lucena VLD, Pernambuco L. Common mental disorders and patient-reported swallowing disorders following total laryngectomy. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/20212368921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2023] Open
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7
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Rossi VC, Guimarães MF, Moreira MJDS, Lopes L, Moreti F. Brazilian choirs of total laryngectomized individuals. Codas 2020; 32:e20190224. [PMID: 33174990 DOI: 10.1590/2317-1782/20202019224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/29/2019] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Michelle Ferreira Guimarães
- Departamento de Voz da Sociedade Brasileira de Fonoaudiologia - SBFa - São Paulo (SP), Brasil.,Comitê de Fononcologia do Departamento de Voz da Sociedade Brasileira de Fonoaudiologia (gestão 2017-2019) - SBFa - São Paulo (SP), Brasil.,Universidade Federal do Espírito Santo - UFES - Vitória (ES), Brasil
| | - Márcio José da Silva Moreira
- Departamento de Voz da Sociedade Brasileira de Fonoaudiologia - SBFa - São Paulo (SP), Brasil.,Comitê de Fononcologia do Departamento de Voz da Sociedade Brasileira de Fonoaudiologia (gestão 2017-2019) - SBFa - São Paulo (SP), Brasil.,Universidade Federal Fluminense - UFF - Nova Friburgo (RJ), Brasil
| | - Leonardo Lopes
- Departamento de Voz da Sociedade Brasileira de Fonoaudiologia - SBFa - São Paulo (SP), Brasil.,Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil
| | - Felipe Moreti
- Departamento de Voz da Sociedade Brasileira de Fonoaudiologia - SBFa - São Paulo (SP), Brasil.,Centro Universitário Saúde ABC/Faculdade de Medicina do ABC - FMABC - Santo André (SP), Brasil.,Complexo Hospitalar Municipal de São Bernardo do Campo - CHMSBC - São Bernardo do Campo (SP), Brasil
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8
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Longobardi Y, Galli J, D'Alatri L, Savoia V, Mari G, Rigante M, Passali GC, Bussu F, Parrilla C. Patients With Voice Prosthesis Rehabilitation During the COVID-19 Pandemic: Analyzing the Effectiveness of Remote Triage and Management. Otolaryngol Head Neck Surg 2020; 164:277-284. [PMID: 32746738 PMCID: PMC7404089 DOI: 10.1177/0194599820948043] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective To describe a remote approach used with patients with voice prosthesis after
laryngectomy during the COVID-19 pandemic and the resulting clinical
outcomes in terms of voice prosthesis complications management, oncological
monitoring, and psychophysical well-being. Study Design Prospective cohort study. Setting Otolaryngology Clinic of the University Polyclinic A. Gemelli, IRCCS
Foundation. Subjects and Methods All patients with voice prosthesis who underwent laryngectomy followed by our
institute were offered enrollment. Patients who agreed to participate were
interviewed to inquire about the nature of the need and to plan a video call
with the appropriate clinician. Before and 1 week after the clinician’s
call, patients were tested with the Hospital Anxiety and Depression Scale.
Degrees of satisfaction were investigated with a visual analog scale. A
comparison between those who accepted and refused telematic support was
carried out to identify factors that influence patient interest in
teleservice. Results Video call service allowed us to reach 37 (50.68%) of 73 patients. In 23
(62.16%) of 37 cases, the video call was sufficient to manage the problem.
In the remaining 14 cases (37.83%), an outpatient visit was necessary.
Participants who refused telematic support had a significantly shorter time
interval from the last ear, nose, and throat visit than patients who
accepted (57.95 vs 96.14 days, P = .03). Video-called
patients showed significantly decreased levels of anxiety and depression
(mean Hospital Anxiety and Depression Scale total score pre– vs post–video
call: 13.97 vs. 10.23, P < .0001) and reported high
levels of satisfaction about the service. Conclusion Remote approach may be a viable support in the management of patients with
voice prosthesis rehabilitation.
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Affiliation(s)
- Ylenia Longobardi
- Unità Operativa Complessa di Otorinolaringoiatria, Area Testa-Collo, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Jacopo Galli
- Unità Operativa Complessa di Otorinolaringoiatria, Area Testa-Collo, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Lucia D'Alatri
- Unità Operativa Complessa di Otorinolaringoiatria, Area Testa-Collo, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Vezio Savoia
- Servizio di Psicologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giorgia Mari
- Unità Operativa Complessa di Otorinolaringoiatria, Area Testa-Collo, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Mario Rigante
- Unità Operativa Complessa di Otorinolaringoiatria, Area Testa-Collo, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Giulio Cesare Passali
- Unità Operativa Complessa di Otorinolaringoiatria, Area Testa-Collo, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Francesco Bussu
- ENT Division, Azienda Ospedaliero Universitaria, Sassari, Italia
| | - Claudio Parrilla
- Unità Operativa Complessa di Otorinolaringoiatria, Area Testa-Collo, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
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9
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Moors T, Silva S, Maraschin D, Young D, Quinn JM, de Carpentier J, Allouche J, Himonides E. Using Beatboxing for Creative Rehabilitation After Laryngectomy: Experiences From a Public Engagement Project. Front Psychol 2020; 10:2854. [PMID: 32082203 PMCID: PMC7001741 DOI: 10.3389/fpsyg.2019.02854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022] Open
Abstract
Laryngectomy is the surgical removal of the larynx (voice box), usually performed in patients with advanced stages of throat cancer. The psychosocial impact of losing the voice is significant, affecting a person’s professional and social life in a devastating way, and a proportion of this patient group subsequently must overcome depression (22–30%) and social isolation (40%). The profound changes to anatomical structures involved in voicing and articulation, as a result of surgery, radiotherapy or chemotherapy (separately or in combination with one another), introduce challenges faced in speech rehabilitation and voice production that complicate social reintegration and quality of life. After laryngectomy, breathing, voicing, articulation and tongue movement are major components in restoring communication. Regular exercise of the chest, neck and oropharyngeal muscles, in particular, is important in controlling these components and keeping the involved structures supple. It is, however, a difficult task for a speech therapist to keep the patient engaged and motivated to practice these exercises. We have adopted a multidisciplinary approach to explore the use of basic beatboxing techniques to create a wide variety of exercises that are seen as fun and interactive and that maximize the use of the structures important in alaryngeal phonation. We herein report on our empirical work in developing patients’ skills, particularly relating to voiced and unvoiced consonants to improve intelligibility. In collaboration with a professional beatboxing performer, we produced instructional online video materials to support patients working on their own and/or with support from speech therapists. Although the present paper is focused predominantly on introducing the structure of the conducted workshops, the rationale for their design and the final public engagement performance, we also include feedback from participants to commence the critical discourse about whether this type of activity could lead to systematic underlying research and robustly assessed interventions in the future. Based on this exploratory work, we conclude that the innovative approach that we employed was found to be engaging, useful, informative and motivating. We conclude by offering our views regarding the limitations of our work and the implications for future empirical research.
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Affiliation(s)
| | | | - Donatella Maraschin
- School of Arts and Creative Industries, London South Bank University, London, United Kingdom
| | - David Young
- School of Science and Engineering, University of Dundee, Dundee, United Kingdom
| | - John M Quinn
- First Faculty of Medicine, Institute of Hygiene and Epidemiology, Charles University, Prague, Czechia
| | | | | | - Evangelos Himonides
- UCL Institute of Education, University College London, London, United Kingdom
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10
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Longobardi Y, Savoia V, Bussu F, Morra L, Mari G, Nesci DA, Parrilla C, D'Alatri L. Integrated rehabilitation after total laryngectomy: a pilot trial study. Support Care Cancer 2019; 27:3537-3544. [PMID: 30685792 DOI: 10.1007/s00520-019-4647-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Acquisition and acceptance of the alaryngeal voice, psychological state, and Quality of Life (QoL) of laryngectomized patients. METHODS Thirty-two patients who underwent total laryngectomy were included in the study; 17 of them were treated by a psychologist and a speech therapist (experimental group); 15 performed only speech therapy (control group). RESULTS The experimental group showed a significant improvement in all parameters of the INFVo scale, in the score of the Environment subscale and in the total score of the I-SECEL (Self-Evaluation of Communication Experiences after Laryngeal Cancer); in the Depression, Obsession-Compulsion and Paranoia areas of the SCL-90-R (Symptom Check List-90-Revised); and in the Social area (REL) of the WHOQOL-B (World Health Organization Quality of Life Scale-Brief). CONCLUSIONS An integrated rehabilitative approach to laryngectomized patients improves emotional state and psychosocial aspects and promotes acceptance and use of the new voice and recovery of a better quality of life.
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Affiliation(s)
- Ylenia Longobardi
- Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy
| | - Vezio Savoia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Unità di Consultazione Psichiatrica, L.go F. Vito 1, I-00168, Rome, Italy
| | - Francesco Bussu
- Otolaryngology Division, AOU Sassari, V.le San Pietro 43/B, I-07100, Sassari, Italy.,Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy
| | - Luciana Morra
- Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy
| | - Giorgia Mari
- Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy
| | - Domenico A Nesci
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Unità di Consultazione Psichiatrica, L.go F. Vito 1, I-00168, Rome, Italy
| | - Claudio Parrilla
- Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy.
| | - Lucia D'Alatri
- Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy
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11
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Singer S, Vogel HJ, Guntinas-Lichius O, Erdmann-Reusch B, Fuchs M, Taylor K, Meyer A, Keszte J. Multicenter prospective study on the use and outcome of rehabilitation after total laryngectomy in Germany. Head Neck 2018; 41:1070-1079. [PMID: 30548728 DOI: 10.1002/hed.25540] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 08/07/2018] [Accepted: 10/06/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the use and outcome of rehabilitation after total laryngectomy in Germany. METHODS We enrolled patients who were scheduled for total laryngectomy, approached them again after surgery, after 3 months and 1 year. Patients completed questionnaires and were interviewed. RESULTS Of 309 participants, 14% had not received any rehabilitation. Reasons for nonuse were primarily ongoing treatment and poor health. Users of rehabilitation had 4 times the odds of attaining any ability to speak compared to nonusers (odds ratio 3.8, P = .02). The main aim of rehabilitation from the perspective of the users was speech rehabilitation, mentioned by 71% before starting rehabilitation. This was also what most users (27%) found the most helpful part of rehabilitation. CONCLUSIONS Patients are interested in attending rehabilitation. They especially want to improve their speech capacity, which indeed is better among users of rehabilitation than in those without.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany.,University Cancer Centre Mainz, Mainz, Germany
| | - Hans-Joachim Vogel
- Department of Otorhinolaryngology, Sana-Klinikum Remscheid, Remscheid, Germany
| | | | | | - Michael Fuchs
- Department of Otorhinolaryngology, Section of Phoniatrics and Audiology, University of Leipzig, Leipzig, Germany
| | - Katherine Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany.,University Cancer Centre Mainz, Mainz, Germany
| | | | - Judith Keszte
- Department of Medical Psychology and Medical Sociology, University Medical Centre Leipzig, Leipzig, Germany
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12
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Bickford JM, Coveney J, Baker J, Hersh D. Self-expression and identity after total laryngectomy: Implications for support. Psychooncology 2018; 27:2638-2644. [PMID: 29927018 DOI: 10.1002/pon.4818] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/03/2018] [Accepted: 06/11/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore how individuals with a laryngectomy (IWL) from diverse backgrounds make meaning and adjust to the physical and functional changes from a total laryngectomy. To examine the extent primary supporters (PS) and health professionals (HP) are able to support IWL with the psychosocial and existential challenges rendered by a surgery that significantly impacts a person's talking, breathing, swallowing, and appearance. METHODS A constructivist grounded theory approach and symbolic interactionism were used to guide data collection and analysis. Semi-structured interviewing occurred. RESULTS Twenty-eight participants (12 IWL, 9 PS, and 7 HP) were interviewed. The findings suggest that IWL experience significant change to their self-identity and there is evidence of a range of passive and active reframing patterns (destabilised, resigned, resolute, and transformed). The loss of self-expression included changes to communicative participation, personal style, food preferences, and social roles. Short and longer-term supports appear to influence outcomes but are often ill-equipped to manage the psychosocial needs of IWL. CONCLUSIONS Loss of self-expression after total laryngectomy influences self-identity and adjustment. How individuals reframe their identity appears to be tied with how they view their disabilities and disfigurement. These perceptions also appear to be influenced by the reactions of others and the support available. Further resourcing, education, and training are needed so that PS and HP can provide holistic care.
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Affiliation(s)
- Jane M Bickford
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - John Coveney
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Janet Baker
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Deborah Hersh
- School of Medical and Health Sciences, Edith Cowan University, Western Australia, Australia
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Bickford J, Coveney J, Baker J, Hersh D. Validating the Changes to Self-identity After Total Laryngectomy. Cancer Nurs 2018; 42:314-322. [PMID: 29846191 DOI: 10.1097/ncc.0000000000000610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A total laryngectomy often prolongs life but results in long-term disablement, disfigurement, and complex care needs. Current clinical practice addresses the surgical options, procedures, and immediate recovery. Less support is available longer-term despite significant changes to aspects of personhood and ongoing medical needs. OBJECTIVE The aim of this study was to explore the experience of living with and/or supporting individuals with a laryngectomy at least 1 year after surgery. METHODS Constructivist grounded theory methods and symbolic interactionism were used to guide collection and analysis of interview data from 28 participants (12 individuals with a laryngectomy, 9 primary supporters, and 7 health professionals). RESULTS The phenomena of "validating the altered self after total laryngectomy" highlighted how individuals, postlaryngectomy, navigate and negotiate interactions due to the disruption of their self-expression, related competencies, and roles. Several reframing patterns representing validation of the self emerged from the narratives. They were as follows: destabilized, resigned, resolute, and transformed. The data describe the influence of the processes of developing competence and building resilience, combined with contextual factors, for example, timing and turning points; being supported; and personal factors on these reframing patterns. CONCLUSION The findings further our understanding of the long-term subjective experience of identity change after laryngectomy and call attention to the persisting need for psychosocial support. IMPLICATIONS FOR PRACTICE This research provides important evidence for evaluating and strengthening the continuum of services (specialist to community) and supporting social participation, regardless of communication method, and for competency training for all involved to optimize person-centered practices.
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Affiliation(s)
- Jane Bickford
- Authors Affiliations: College of Nursing and Health Sciences, Flinders University, Adelaide (Dr Bickford and Adjunct Associate Professor Baker and Professor Coveney); and School of Medicine and Health Sciences, Edith Cowan University, Western Australia (Associate Professor Hersh)
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14
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Social and quality of life impact using a voice prosthesis after laryngectomy. Curr Opin Otolaryngol Head Neck Surg 2017; 25:188-194. [DOI: 10.1097/moo.0000000000000361] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Saltürk Z, Arslanoğlu A, Özdemir E, Yıldırım G, Aydoğdu İ, Kumral TL, Berkiten G, Atar Y, Uyar Y. How do voice restoration methods affect the psychological status of patients after total laryngectomy? HNO 2016; 64:163-8. [PMID: 26923487 DOI: 10.1007/s00106-016-0134-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study investigated the relationship between psychological well-being and different voice rehabilitation methods in total laryngectomy patients. METHODS The study enrolled 96 patients who underwent total laryngectomy. The patients were divided into three groups according to the voice rehabilitation method used: esophageal speech (24 patients); a tracheoesophageal fistula and Provox 2 voice prosthesis (57 patients); or an electrolarynx (15 patients). The participants were asked to complete the Turkish version of the Voice Handicap Index-10 (VHI-10) to assess voice problems. They were also asked to complete the Turkish version of the Perceived Stress Scale (PSS), and the Hospital Anxiety and Depression Scale (HADS). The test scores of the three groups were compared statistically. RESULTS Patients who used esophageal speech had a mean VHI-10 score of 10.25 ± 3.22 versus 19.42 ± 5.56 and 17.60 ± 1.92 for the tracheoesophageal fistula and Provox 2 and electrolarynx groups respectively, reflecting better perception of their voice. They also had a PSS score of 11.38 ± 3.92, indicating that they felt less stressed in comparison with the tracheoesophageal fistula and Provox 2 and electrolarynx groups, which scored 18.84 ± 5.50 and 16.20 ± 3.49 respectively. The HADS scores of the groups were not different, indicating that the patients' anxiety and depression status did not vary. CONCLUSION Patients who used esophageal speech perceived less stress and were less handicapped by their voice.
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Affiliation(s)
- Z Saltürk
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey.
| | - A Arslanoğlu
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - E Özdemir
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - G Yıldırım
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - İ Aydoğdu
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - T L Kumral
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - G Berkiten
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - Y Atar
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - Y Uyar
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
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Keszte J, Danker H, Dietz A, Meister E, Pabst F, Guntinas-Lichius O, Oeken J, Singer S, Meyer A. Course of psychiatric comorbidity and utilization of mental health care after laryngeal cancer: a prospective cohort study. Eur Arch Otorhinolaryngol 2016; 274:1591-1599. [PMID: 27744529 DOI: 10.1007/s00405-016-4340-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Abstract
In a German multi-center prospective cohort study, we wanted to assess the course of psychiatric comorbidity, utilization of mental health care and psychosocial care needs in laryngeal cancer patients during the first year after partial laryngectomy (PRL). Structured interviews with patients were conducted before surgery, 1 week (1 w), 3 months (3 m) and 1 year (12 m) after PRL. Psychiatric comorbidity was assessed using the Structured Clinical Interview for DSM-IV (SCID). Psychosocial care needs and utilization of mental health care were evaluated with standardized face-to-face interviews. In 176 patients, psychiatric disorders were prevalent in 11 % (1 w), 15 % (3 m) and 14 % (12 m), respectively, of which 4 % (12 m) underwent psychiatric treatment or psychotherapy. Two percent had acute, 15 % emerging and 6 % chronic psychiatric comorbidity. Chronically mental ill patients were more frequently younger than 65 years (p = 0.026), female (p = 0.045) and experienced more often a need for psychological counseling (p ≤ 0.001). One year after surgery, 27 % of the comorbid psychiatric patients expressed a need for additional psychological counseling. Alcohol-related disorders were diagnosed in 3 % (1 w), 3 % (3 m) and 8 % (12 m), respectively. Only one of these patients received psychological treatment, while 14 % expressed a need for psychological counseling and 7 % for additional medical consultations. The non-treatment of alcohol-related disorders measured in our sample indicates a major problem since continued alcohol consumption in laryngeal cancer patients is associated with reduced global quality of life, increased functional impairments and reduced overall survival. Screening instruments integrated into acute care are necessary to detect harmful drinking behavior.
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Affiliation(s)
- J Keszte
- Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany.
| | - H Danker
- Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany
| | - A Dietz
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center, Leipzig, Germany
| | - E Meister
- Department of Otorhinolaryngology, Clinical Center Sankt Georg, Leipzig, Germany
| | - F Pabst
- Department of Otorhinolaryngology, Clinical Center Dresden-Friedrichstadt, Dresden, Germany
| | - O Guntinas-Lichius
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital, Jena, Germany
| | - J Oeken
- Department of Otorhinolaryngology, Clinical Center Chemnitz, Chemnitz, Germany
| | - S Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Mainz, Germany
| | - A Meyer
- Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany
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Meyer A, Keszte J, Wollbrück D, Dietz A, Oeken J, Vogel HJ, Koscielny S, Breitenstein K, Meister EF, Pabst F, Schock J, Bourkas S, Singer S. Psychological distress and need for psycho-oncological support in spouses of total laryngectomised cancer patients—results for the first 3 years after surgery. Support Care Cancer 2014; 23:1331-9. [DOI: 10.1007/s00520-014-2485-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 10/14/2014] [Indexed: 10/24/2022]
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