Speech restoration with tracheoesophageal prosthesis after total laryngectomy: An observational study of vocal results, complications and quality of life

OBJECTIVES

To study voice prosthesis survival, complications, efficacy and impact on quality of life.

METHODS

A single-center observational study was performed in patients treated for squamous cell carcinoma of the larynx or hypopharynx by total (pharyngo)-laryngectomy between 2010 and 2015. Study data comprised: maximum phonation time (sec), number of and reasons for prosthesis exchanges (leakage through or around the prosthesis, expulsion or inclusion of the prosthesis), plus 2 quality of life questionnaires (QLQ-C30, QLQ-H&N35) and the Voice Handicap Inventory (VHI 30).

RESULTS

Forty-nine patients were included. The most common causes of prosthesis exchange were leakage through (73.2%) or around the prosthesis (18.5%). The median time between exchanges was 4 months. Global quality of life status on the QLQ-C30 was 63.5. Mean maximum phonation time was 7.4sec. Mean VHI was 46/120; 10 patients had a mild voice handicap, 12 moderate and 10 severe. No relation emerged between the number of prosthesis exchanges per year and quality of life. Voice handicap significantly decreased quality of life, with QLQ-C30 72.3 for the 22 patients with mild to moderate voice handicap and 44.2 for the 10 patients with severe voice handicap (P=0.001).

CONCLUSION

Voice restoration by tracheoesophageal prosthesis after total (pharyngo)-laryngectomy is a reliable technique that decreases voice handicap and, despite potentially serious complications, has little negative impact on quality of life.

Impact of head and neck cancer on partner's sociability

INTRODUCTION

"Sociability" is defined as the range of experiences linking the subject to others. This is the first study to focus specifically on the impact of head and neck cancer on the sociability of patients' partners.

METHOD

Data were collected via a dedicated questionnaire sent to patients' partners. The main endpoint was partner's self-assessment of the impact of the patient's disease on the partner's everyday life. The impact on sociability was analyzed with respect to: the circle of friends (friendship environment), unknown environment, known outside environment, necessary environment, and solitary activities.

RESULTS

Two hundred and seventy partners responded. Their everyday activities were impacted by the patient's disease in 71.5% of cases. The friendship environment was badly affected in 46.4% of cases. The unknown environment was affected in 44.0% of cases. Social practices related to the known outside environment were affected in 67.8% of cases, and the necessary environment in 26.0%; the number of solitary activities increased in 35.6% of cases. Social impact on patients' partners was thus considerable.