QOL decreases initially after laryngectomy; some QOL areas recover slowly over the course of the year after surgery, and some remain significantly worse than at baseline.

Percutaneous dilational tracheostomy (PDT) has replaced conventional tracheostomy for long-term intubated patients in many intensive care units (ICUs). In a prospective study carried out between September 1994 and August 1996, 76 patients underwent PDT. In 41 patients, PDT was performed "blind." In 35 patients it was executed with simultaneous bronchoscopic monitoring. The type and rate of complications of the two techniques were compared. Comparing the groups with and without bronchoscopy, the perioperative complication rate was equivalent (7% vs 6%); however, more severe complications occurred in the group without bronchoscopy (one death due to tension pneumothorax, two cases of perforating the rear tracheal wall) than in the group with bronchoscopy (two cases of intratracheal hemorrhage). PDT is a suitable bedside method for ICU patients undergoing long-term ventilation. Simultaneous endoscopy minimizes the severity of complications.

These results confirm that a significant minority of laryngeal cancer patients suffer from severe mental distress, and that accurate screening for clinically significant mental disorders is possible using any of the instruments evaluated here.

Speech improves considerably between 6 months and 1 year after total laryngectomy. Nonattendance of rehabilitation is associated with a worse functional outcome in speech rehabilitation.

Background. The aim of this study was to test the validity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core Module (QLQ-C30) and Head and Neck Module (QLQ-H&N35) for patients who have undergone surgery due to laryngeal cancer.Methods. A total of 323 patients from 6 different centers in Germany who had been operated on completed the QLQ-C30 and the QLQ-H&N35 in addition to being surveyed in a personal interview.Results. Multitrait scaling analysis confirmed the proposed scale structure of both questionnaires. Cronbach's alpha of the QLQ-C30 scales ranged from 0.64 (Cognitive Functioning) to 0.94 (Global Health Status); the alpha of the QLQ-H&N35 ranged from 0.55 (Speech) to 0.90 (Sexuality). Known-groups comparisons showed multiple differences in sociodemographic and clinical variables.Conclusion. It can be concluded that the QLQ-H&N35, in conjunction with the QLQ-C30, is a reliable instrument that is able to differentiate between diverse groups of patients with laryngeal cancer after surgery. V