General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. 2 AbstractPurpose of Review Total laryngectomy rehabilitation (TLR) in Europe is not uniform, with quite some differences in approach and infrastructure between the various countries. In e.g. the Netherlands, Switzerland, Scandinavia, and more recently also in the UK, Head and Neck Cancer treatment and rehabilitation shows a high level of centralisation in dedicated HNC centres. In other European countries, the level of centralisation is lower, with more patients treated in lowvolume hospitals. This paper focuses on the situation in the Netherlands, and where applicable, will discuss regional variations in Europe.Recent Findings Prosthetic surgical voice restoration (PSVR) presently is method of choice in Europe, and use of oesophageal and electrolarynx voice has moved to the background. In most European countries (except UK and Ireland), PSVR is physician driven, with an indispensable role for Speech Language Pathologists, and increasingly for oncology nurses. Indwelling voice prostheses are mostly preferred, also because these devices can be implanted at the time of tracheaoesophageal puncture. Pulmonary rehabilitation is achieved with heat and moisture exchangers, which, based on extensive clinical and basic physiology research, are considered an obligatory therapy measure. Besides PSVR, also issues such as smoking cessation, dysphagia/swallowing rehabilitation, and olfaction/taste rehabilitation are discussed. Especially the latter has shown great progress over the last decade, and is another example of increasing implementation of evidence-based practice in TLR.Summary TLR has shown considerable progress over the last decades, and through the intensified collaboration between all clinicians involved, significantly has improved vocal, pulmonary, and olfactory rehabilitation after TL. KeywordsTotal laryngectomy; voice rehabilitation; pulmonary rehabilitation; olfactory rehabilitation; swallowing rehabilitation; multidisciplinary approach Bullet list  Prosthetic Surgical Voice Restoration is the method of choice for re-establishing postlaryngectomy oral communication, ensuring early regain of optimal voice and speech quality  As with any surgical method, adverse events have to be taken into account, but clinica...

The new criteria show an increased sensitivity to ototoxicity compared to CTCAEv4 and ASHA and provide insight into the effect of hearing loss on certain daily life situations. The new grading system seems feasible for clinic and research purposes.

Objective: To illustrate a case of sensorineural hearing loss (SNHL) after immunotherapy based on T cell receptor (TCR) gene therapy using modified T cells recognizing melanoma antigen recognized by T cells 1 for disseminated melanoma. Patient: We present a 59-year-old woman with profound subacute bilateral SNHL including unilateral deafness after immunotherapy based on TCR gene therapy using modified T cells recognizing melanoma antigen recognized by T cells 1 for disseminated melanoma. Ten days after treatment, the patient developed hearing loss of 57 dB hearing loss air conduction at pure-tone average 0.5–1–2–4 kHz in the right ear, and >100 dB hearing loss air conduction at pure-tone average 0.5–1–2–4 in the left ear. The right ear recovered partially, while the left ear remained deaf, despite oral prednisolone (1.0 mg/kg) and salvage treatment with three transtympanic injections of 0.5 ml dexamethasone (4.0 mg/ml). Conclusion: Based on our presented case and a vast amount of literature there is circumstantial evidence that TCR gene therapy for melanoma targets the perivascular macrophage-like melanocytes in the stria vascularis, resulting in SNHL. We suggest that SNHL after TCR gene therapy may be caused by a disruption of the blood–labyrinth–barrier and the endolymphatic potential and/or a sterile inflammation of the stria vascularis. In severe cases like our subject, we posit that endolymphatic hydrops or hair cell loss may cause irreversible and asymmetrical deafness. Steroid prophylaxis via transtympanic application is debatable.