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Varghese JJ, Aithal VU, Suresh K, Bellur R, R B. Voice prosthesis experience of Indian laryngectomees: Preliminary findings from a tertiary hospital in South India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Tsao CK, Marchi F, Kang CJ, Sampieri C, Lu YA, Huang SF, Chen YT, Giordano G, Peretti G, Parrinello G, Iandelli A, Fang TJ. Comprehensive Evaluation of Vocal Outcomes and Quality of Life after Total Laryngectomy and Voice Restoration with J-Flap and Tracheoesophageal Puncture. Cancers (Basel) 2022; 14:cancers14030544. [PMID: 35158812 PMCID: PMC8833548 DOI: 10.3390/cancers14030544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Laryngopharyngectomy is still the treatment of choice in locally advanced pharyngolaryngeal tumors not eligible for organ preservation protocols. Loss of speech capacity has been reported as one of the factors that most affect the patient-reported quality of life. Thus, the reconstructive goals are restoring the pharynx and possibly the voice in such a scenario. For decades, tracheoesophageal puncture (TEP) has allowed proper voice rehabilitation; however, TEP has a non-neglectable financial expenditure and complication rate. Therefore, we recently reported a novel flap design and surgical technique that shares the same principles of TEP, without the need to change any device over time, named J-flap. This study aimed to analyze both techniques’ subjective and objective vocal outcomes and their impact on overall and voice-related quality of life. Abstract Background: Tracheoesophageal puncture with a voice prosthesis is the gold standard for speech rehabilitation in patients that receive a laryngopharyngectomy. However, a novel surgical technique, using a tubularized anterolateral tight flap, named “J-flap,” has been demonstrated to produce adequate voice restoration. We aimed to compare the outcomes and the quality of life of patients who underwent voice rehabilitation with both techniques. Methods: We enrolled patients that underwent laryngopharyngectomy and voice restoration surgery. The control group received a tracheoesophageal puncture with a voice prosthesis, while the study group received J-flap reconstruction. A total of 20 patients received voice prosthesis rehabilitation, while 18 received J-flap reconstruction. Speech and vocal outcomes and quality of life metrics were collected. Results: The objective phonatory performances and the acoustic voice analysis did not outline a significant difference. Speech pathologists judged the consonant pronunciation in the J-flap group as less accurate (p < 0.001). The voice handicap index revealed a moderate impairment for the J-flap group (p < 0.001). Quality of life scores were higher for the voice prosthesis group. Conclusion: Voice prostheses and J-flaps share similar objective phonatory outcomes. Quality of life was more impaired in the J-flap group. In our view, these two techniques possess complementary characteristics in clinical practice, taking into account health care system regulations and patients’ social background.
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Affiliation(s)
- Chung-Kan Tsao
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-K.T.); (F.M.); (Y.-T.C.)
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Filippo Marchi
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-K.T.); (F.M.); (Y.-T.C.)
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Chung-Jan Kang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-J.K.); (Y.-A.L.); (S.-F.H.)
| | - Claudio Sampieri
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Yi-An Lu
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-J.K.); (Y.-A.L.); (S.-F.H.)
| | - Shiang-Fu Huang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-J.K.); (Y.-A.L.); (S.-F.H.)
| | - Yu-Ting Chen
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-K.T.); (F.M.); (Y.-T.C.)
| | - Giorgio Giordano
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Giorgio Peretti
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Giampiero Parrinello
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Andrea Iandelli
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-J.K.); (Y.-A.L.); (S.-F.H.)
- Correspondence: (A.I.); (T.-J.F.)
| | - Tuan-Jen Fang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-J.K.); (Y.-A.L.); (S.-F.H.)
- Correspondence: (A.I.); (T.-J.F.)
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Massaro N, Verro B, Greco G, Chianetta E, D'Ecclesia A, Saraniti C. Quality of Life with Voice Prosthesis after Total Laryngectomy. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2021; 33:301-309. [PMID: 34692577 PMCID: PMC8507945 DOI: 10.22038/ijorl.2021.53724.2832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 07/24/2021] [Indexed: 11/06/2022]
Abstract
Introduction The loss of voice after total laryngectomy is one of the main impairments in personal and social life. In order to prevent potential psycho-social consequences in the patient and his family, the restoration of phonatory function is the main objective of post-laryngectomy rehabilitation. The aim of this study was to assess quality of life in patients who received prosthetic voice after total laryngectomy. Materials and Methods Over a one-year period, 51 patients with voice prostheses after total laryngectomy were recruited. 32 patients (62.74%) were administered radiation therapy and 9 patients (17.64%) underwent to surgical reconstruction with flaps. Each patient was administered the VHI-10 and V-RQOL self-assessment questionnaires. Results The study showed that vocal restoration with voice prosthesis allows patients to recover a significant degree of quality of life after total laryngectomy. The average score on the V-RQOL questionnaire was 75.9 and on the VHI-10 questionnaire was 13.5. It has not been shown a statistically significant correlation between quality of life after tracheoesophageal prosthesis and radiation therapy, chemotherapy or reconstruction flaps. Younger patients showed, on average, a higher score at V-RQOL. These results allow to state that, after prosthetic rehabilitation, at least 75% of patients experienced an increase in quality of life. Moreover, the prosthetic technique (primary vs secondary) does not affect the long-term outcome and radiotherapy, chemotherapy or reconstruction flaps are not absolute contraindications to rehabilitation with voice prosthesis. Conclusion After total laryngectomy, rehabilitation with tracheoesophageal prosthesis is a satisfactory choice to restore the patient's ability to communicate verbally.
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Affiliation(s)
- Nicola Massaro
- Department of Biomedicine, Neurosciences and Advanced Diagnostic, University of Palermo, Palermo (PA) Italy
| | - Barbara Verro
- Department of Biomedicine, Neurosciences and Advanced Diagnostic, University of Palermo, Palermo (PA) Italy
| | - Giuseppe Greco
- Department of Biomedicine, Neurosciences and Advanced Diagnostic, University of Palermo, Palermo (PA) Italy
| | - Enzo Chianetta
- Department of Biomedicine, Neurosciences and Advanced Diagnostic, University of Palermo, Palermo (PA) Italy
| | - Aurelio D'Ecclesia
- ENT and Maxillo-Facial Clinic, IRCSS - Casa Sollievo Della Sofferenza - San Giovanni Rotondo, Foggia (FG), Italy
| | - Carmelo Saraniti
- Department of Biomedicine, Neurosciences and Advanced Diagnostic, University of Palermo, Palermo (PA) Italy
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Iype EM, Janardhanan D, Patil S, Suresh S, Varghese BT, Thomas S. Voice Rehabilitation After Laryngectomy: A Regional Cancer Centre Experience and Review of Literature. Indian J Otolaryngol Head Neck Surg 2020; 72:518-523. [PMID: 33088785 DOI: 10.1007/s12070-019-01707-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022] Open
Abstract
Alaryngeal speech in laryngectomees has revolutionized the patient outlook toward the morbid procedure and the concept of permanent stoma unlike olden era when stigma of stoma with loss of voice was rampant. To analyse acceptance of voice rehabilitation options and their success and management of complications in a tertiary care centre. All patients who underwent laryngectomy from August 2014 to 2018 June at our institution were included in the study. The voice rehabilitation options like oesophageal speech, tracheao-oesophageal puncture and voice prosthesis insertion (TEP), and electrolarynx were explained to the patients. The options put forward to the patients, the importance of Taub test, Interval between treatment and secondary TEP insertion, life span of the prosthesis, Patients acceptance and success rates and the troubleshooting were noted. A total of 96 patients underwent total laryngectomy, 72 patients were willing for rehabilitation. 15% (11) patients had primary TEP, 22% (16) had secondary TEP insertion, esophageal speech in 36% (26) patients and 27% (19) patients opted for the electrolarynx. The rest 24 patients were not keen on any further interventions after laryngectomy. Speech rehabilitation is an integral part in surgical management of carcinoma of the larynx. Alaryngeal speech in laryngectomees have revolutionized the patient outlook towards the morbid procedure. Esophageal speech is the least successful method of rehabilitation but still the cheapest method and requires a lot of motivation. Primary and Secondary TEP insertions have similar success rates. Successful treatment for cancer of larynx ends with successful voice rehabilitation.
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Affiliation(s)
- Elizabeth Mathew Iype
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala 695011 India
| | - Deepak Janardhanan
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala 695011 India
| | - Shirish Patil
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala 695011 India
| | - Sandeep Suresh
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala 695011 India
| | - Bipin T Varghese
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala 695011 India
| | - Shaji Thomas
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala 695011 India
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Raquel ACS, Buzaneli EP, Lima Silveira HS, Simões-Zenari M, Kulcsar MAV, Kowalski LP, Nemr K. Quality of life among total laryngectomized patients undergoing speech rehabilitation: correlation between several instruments. Clinics (Sao Paulo) 2020; 75:e2035. [PMID: 33206762 PMCID: PMC7603229 DOI: 10.6061/clinics/2020/e2035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study was to correlate several instruments currently used for the assessment of the quality of life of patients who underwent total laryngectomy and speech rehabilitation. METHODS A cross-sectional, observational study was conducted with 38 patients after total laryngectomy and speech therapy aiming to develop oesophageal speech. The patients were divided into the following two groups (19 participants each): speakers and non-speakers. The quality of life instruments used were as follows: visual analogue scale (VAS); Voice Handicap Index (VHI); Voice-Related Quality of Life (V-RQOL); Functional Assessment of Cancer Therapy - Head & Neck (FACT-H&N); European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck (EORTC QLQ-H&N35); and University of Washington Quality of Life (UW-QOL). RESULTS The V-RQOL global health domain exhibited a strong correlation with the VHI. The EORTC QLQ-C30 exhibited a moderate to strong correlation with the EORTC QLQ-H&N35 functional domain in both groups. The EORTC QLQ-C30 functional domain exhibited a strong to moderate correlation with all other instruments in both groups. The UW-QOL exhibited a moderate to strong correlation with the VHI and EORTC QLQ-C30 in both groups. CONCLUSION The EORTC QLQ-C30, EORTC QLQ-H&N35 and UW-QOL were the instruments that most correlated with the remaining instruments, indicating that any of the three can be used to assess the quality of life of the target population regardless of oesophageal voice development.
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Affiliation(s)
- Ana Carolina Soares Raquel
- Programa de pos-graduacao em Ciencias da reabilitacao, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Elaine Pires Buzaneli
- Programa de pos-graduacao em Ciencias da reabilitacao, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Hevely Saray Lima Silveira
- Programa de pos-graduacao em Ciencias da reabilitacao, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marcia Simões-Zenari
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | | | - Luiz Paulo Kowalski
- Departamento de Cirurgia - Cirurgia de Cabeça e Pescoço, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Kátia Nemr
- Programa de pos-graduacao em Ciencias da reabilitacao, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, BR
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Kaye R, Tang CG, Sinclair CF. The electrolarynx: voice restoration after total laryngectomy. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2017; 10:133-140. [PMID: 28684925 PMCID: PMC5484568 DOI: 10.2147/mder.s133225] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The ability to speak and communicate with one’s voice is a unique human characteristic and is fundamental to many activities of daily living, such as talking on the phone and speaking to loved ones. When the larynx is removed during a total laryngectomy (TL), loss of voice can lead to a devastating decrease in a patient’s quality of life, and precipitate significant frustration over their inability to communicate with others effectively. Over the past 50 years there have been many advances in techniques of voice restoration after TL. Currently, there are three main methods of voice restoration: the electrolarynx, esophageal speech, and tracheoesophageal speech through a tracheoesophageal puncture (TEP) with voice prosthesis. Although TEP voice is the current gold standard for vocal rehabilitation, a significant minority of patients cannot use or obtain TEP speech for various reasons. As such, the electrolarynx is a viable and useful alternative for these patients. This article will focus on voice restoration using an electrolarynx with the following objectives: 1) To provide an understanding of the importance of voice restoration after total laryngectomy. 2) To discuss how the electrolarynx may be used to restore voice following total laryngectomy. 3) To outline some of the current electrolarynx devices available, including their mechanism of action and limitations. 4) To compare pros and cons of electrolaryngeal speech to TEP and esophageal speech.
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Affiliation(s)
- Rachel Kaye
- Department of Otolaryngology, New York Center for Voice and Swallowing Disorders, New York, NY
| | - Christopher G Tang
- Department of Otolaryngology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA
| | - Catherine F Sinclair
- Department of Otolaryngology, Mount Sinai Icahn School of Medicine, New York, NY, USA
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Kotake K, Suzukamo Y, Kai I, Iwanaga K, Takahashi A. Social support and substitute voice acquisition on psychological adjustment among patients after laryngectomy. Eur Arch Otorhinolaryngol 2016; 274:1557-1565. [PMID: 27687680 PMCID: PMC5309287 DOI: 10.1007/s00405-016-4310-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 09/15/2016] [Indexed: 12/17/2022]
Abstract
The objective is to clarify whether social support and acquisition of alternative voice enhance the psychological adjustment of laryngectomized patients and which part of the psychological adjustment structure would be influenced by social support. We contacted 1445 patients enrolled in a patient association using mail surveys and 679 patients agreed to participate in the study. The survey items included age, sex, occupation, post-surgery duration, communication method, psychological adjustment (by the Nottingham Adjustment Scale Japanese Laryngectomy Version: NAS-J-L), and the formal support (by Hospital Patient Satisfaction Questionnaire-25: HPSQ-25). Social support and communication methods were added to the three-tier structural model of psychological adjustment shown in our previous study, and a covariance structure analysis was conducted. Formal/informal supports and acquisition of alternative voice influence only the "recognition of oneself as voluntary agent", the first tier of the three-tier structure of psychological adjustment. The results suggest that social support and acquisition of alternative voice may enhance the recognition of oneself as voluntary agent and promote the psychological adjustment.
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Affiliation(s)
- Kumiko Kotake
- Faculty of Nursing, Nara Medical University, 840 Shijou-cho, Kashihara City, Nara, 634-8521, Japan.
| | - Yoshimi Suzukamo
- Physical Medicine and Rehabilitation, Tohoku University School of Medicine, Tohoku, Japan
| | - Ichiro Kai
- Faculty of Nursing, Nara Medical University, 840 Shijou-cho, Kashihara City, Nara, 634-8521, Japan.,Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuyo Iwanaga
- Faculty of Nursing, Nara Medical University, 840 Shijou-cho, Kashihara City, Nara, 634-8521, Japan.,Faculty of Medicine, School of Nursing, Fukuoka University, Fukuoka, Japan
| | - Aya Takahashi
- Faculty of Nursing, Nara Medical University, 840 Shijou-cho, Kashihara City, Nara, 634-8521, Japan.,Department of Nursing, Saitama Prefectural University, Saitama, Japan
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Structured review of papers reporting specific functions in patients with cancer of the head and neck: 2006 - 2013. Br J Oral Maxillofac Surg 2016; 54:e45-51. [PMID: 26923873 DOI: 10.1016/j.bjoms.2016.02.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 02/09/2016] [Indexed: 11/21/2022]
Abstract
Health-related quality of life (HRQoL) focuses on 4 core domains: physical and psychological function, social interaction, disease, and treatment-related symptoms, and is a key outcome in patients with cancer of the head and neck. We reviewed papers published between 2006 and 2013 that used validated questionnaires to report functional outcome in this group. A total of 572 papers were identified and 118 of them concerned function. Specific outcomes included anxiety, chewing, maxillectomy, mucositis, pain, shoulder function, and trismus. The specific functions most often identified were xerostomia, speech or voice, and swallowing or dysphagia. A considerable body of evidence has now accumulated on HRQoL and functional outomes although the precise role of HRQoL during the planning of treatment remains controversial. Over time, the emphasis of the studies included has tended to move away from the reporting of outcomes in general to more hypothesis-driven and group-specific work.
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Luo J, Wu J, Lv K, Li K, Wu J, Wen Y, Li X, Tang H, Jiang A, Wang Z, Wen W, Lei W. Analysis of Postsurgical Health-Related Quality of Life and Quality of Voice of Patients With Laryngeal Carcinoma. Medicine (Baltimore) 2016; 95:e2363. [PMID: 26735538 PMCID: PMC4706258 DOI: 10.1097/md.0000000000002363] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
This study aims to analyze the postsurgical health-related quality of life (HRQOL) and quality of voice (QOV) of patients with laryngeal carcinoma with an expectation of improving the treatment and HRQOL of these patients. Based on the collection of information of patients with laryngeal carcinoma regarding clinical characteristics (age, TNM stage, with or without laryngeal preservation and/or neck dissection, with or without postoperative irradiation and/or chemotherapy, etc.), QOV using Voice Handicap Index (VIH) scale and HRQOL using EORTC QLQ-C30 and EORTCQLQ-H&N35 scales, the differences of postsurgical HRQOL related to their clinical characteristics were analyzed using univariate nonparametric tests, the main factors impacting the postsurgical HRQOL were analyzed using regression analyses (generalized linear models) and the correlation between QOV and HRQOL analyzed using spearman correlation analysis. A total of 92 patients were enrolled in this study, on whom the use of EORTC QLQ-C30, EORTC QLQ-H&N35 and VHI scales revealed that: the differences of HRQOL were significant among patients with different ages, TNM stages, and treatment modalities; the main factors impacting the postsurgical HRQOL were pain, speech disorder, and dry mouth; and QOV was significantly correlated with HRQOL. For the patients with laryngeal carcinoma included in our study, the quality of life after open surgeries were impacted by many factors predominated by pain, speech disorder, and dry mouth. It is suggested that doctors in China do more efforts on the patients' postoperative pain and xerostomia management and speech rehabilitation with the hope of improving the patients' quality of life.
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Affiliation(s)
- Jie Luo
- From the Otorhinolaryngology Hospital, Otorhinolaryngology Institute, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China (JL, JL W(Jieli Wu), KX L(Kexing Lv), YW, HT, AJ, ZW, WW, WL); Tianyou Hospital Affiliated to Tongji University, Shanghai, China (JL, KC L(Kaichun Li)); Otorhinolaryngology Institute, Meizhou People's Hospital, Meizhou, Guangdong, China (JW); and The Fourth People's Hospital of Shenzhen (Affiliated Futian Hospital of Guangdong Medical College), Shenzhen, China (XL)
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Nagy J, Braunitzer G, Antal M, Berkovits C, Novák P, Nagy K. Quality of life in head and neck cancer patients after tumor therapy and subsequent rehabilitation: an exploratory study. Qual Life Res 2013; 23:135-43. [PMID: 23733663 DOI: 10.1007/s11136-013-0446-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the study was to evaluate patient-reported quality of life effects of post-treatment intraoral and extraoral rehabilitation in head and neck cancer by repeated measures. METHODS Fifty-nine patients were involved. Basic socio-demographic, oncological and epidemiological data were gathered, and the type of rehabilitation was recorded. For the assessment of quality of life changes, two widely used brief questionnaires, the University of Washington Quality of Life Questionnaire and the Head and Neck module of the European Organization of Research and Treatment for Cancer Quality of Life Questionnaire, were used. The questionnaires were administered to patients two times: the first time after tumor therapy, but before rehabilitation (upon arriving for rehabilitation) and the second time 6 months after the application of any particular method of rehabilitation. Quality of life data were gathered prospectively, while socio-demographic data were gathered from patient files. RESULTS Quality of life after rehabilitation was significantly enhanced as compared to the post-treatment status, in all domains of both questionnaires (p < 0.05 and p < 0.01, Mann-Whitney U). CONCLUSIONS The results support the hypothesis that post-treatment maxillofacial rehabilitation in head and neck cancer does not only restore lost physical capabilities, but also brings about profound changes in patients' quality of life in general.
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Affiliation(s)
- Judit Nagy
- Department of Oral Surgery, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64, 6720, Szeged, Hungary
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Varghese BT, Mathew A, Sebastian S, Iype EM, Sebastian P, Rajan B. Objective and perceptual analysis of outcome of voice rehabilitation after laryngectomy in an Indian tertiary referral cancer centre. Indian J Otolaryngol Head Neck Surg 2013; 65:150-4. [PMID: 24427633 DOI: 10.1007/s12070-013-0647-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 03/13/2013] [Indexed: 11/25/2022] Open
Abstract
Post laryngectomy voice rehabilitation is very challenging in centres with limited resources because of cost concerns and morbidity. A study of laryngectomised voice rehabilitated patients on follow up was performed to look into overall quality of life (QOL), morbidity and voice quality. Those patients who had visited head and neck surgical outpatient department during the period of January 2008 to October 2009 were evaluated for their QOL, morbidity and voice quality, objectively and subjectively. Voice rating and QOL rating showed a distinct discrepancy which could be explained by the morbidity recorded for surgical voice restoration in the present study. Voice rehabilitation strategy after laryngectomy in a low resource setting has to take in account financial social educational background of the patient besides technical issues.
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Affiliation(s)
- B T Varghese
- Division of Surgical Oncology (Head and Neck Service), Regional Cancer Centre, Trivandrum, India
| | - A Mathew
- Division of Clinical Epidemiology, Regional Cancer Centre, Trivandrum, India
| | - S Sebastian
- Department of Speech and Language Pathology, Mar Thoma College of Speech and Language, Kasargod, India
| | - E M Iype
- Division of Surgical Oncology (Head and Neck Service), Regional Cancer Centre, Trivandrum, India
| | - P Sebastian
- Division of Surgical Oncology (Head and Neck Service), Regional Cancer Centre, Trivandrum, India
| | - B Rajan
- Department of Oncology, National Oncology Centre, Royal Hospital, Muscat, Oman
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