Communication changes with laryngectomy and impact on quality of life: a review

Sharpe, Gabriella; Costa, Vera Camões; Doubé, Wendy; Sita, Jodi; McCarthy, Christopher; Carding, Paul

doi:10.1007/s11136-018-2033-y

Cited by 43 publications

(32 citation statements)

References 21 publications

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“…As we move towards health models driven by patientcentred care, understanding the differential impacts of surgical procedures on subgroups of our patients, in this case women, is critically important to help improve our care models, patient education and support systems. We support the conclusions of earlier research recommending personalized rehabilitation provided by a multidisciplinary team and recognize the presence of unmet supportive care needs in women undergoing total laryngectomy (Bickford et al 2013, Eadie et al 2018, Perry et al 2015, Passchier et al 2016, Lee et al 2010, Sharpe et al 2019, Jansen et al 2018.…”

Section: Recommendations For Clinical Practicesupporting

confidence: 86%

Women's perspective on life after total laryngectomy: a qualitative study

Sluis

Kornman

Molen

et al. 2019

Intl J Lang & Comm Disor

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Background Physical and psychosocial challenges are common after total laryngectomy. The surgery leads to lifelong changes in communication, airway, swallowing and appearance. As we move towards health models driven by patient‐centred care, understanding the differential impacts of surgical procedures on subgroups of patients can help improve our care models, patient education and support systems. This paper discusses the experiences of women following total laryngectomy. Aims To gain an insight into the impact of total laryngectomy on women's daily life while identifying their specific rehabilitation needs. Methods & Procedures This paper is based on in‐depth, semi‐structured interviews with eight women who had undergone total laryngectomy. These interviews were conducted with women at least 1 year after they had undergone total laryngectomy, and the participants did not have recurrent disease. Using an interview guide, participants were encouraged to discuss their everyday experiences, while also focusing on issues typical to women. The transcribed interview data were analysed by thematic analysis, taking interpretative phenomenological analysis as a lead. Outcomes & Results The interviews revealed three main themes: disease and treatment as a turning point, re‐establishing meaningful everyday activities, and persistent vulnerability. Participants reported experiencing challenges in their rehabilitation process due to physical disabilities, dependency on others and experienced stigma. Women‐specific challenges arose in dealing with the altered appearance and voice, performing care activities, and the spousal relationship (including intimacy). Conclusions & Implications Women who undergo total laryngectomy are likely to experience issues in returning to work, the performance of informal care‐work, the spousal relationship, intimacy and social interaction due to stigmatization. Medical pretreatment counselling and multidisciplinary rehabilitation programmes should help patients form realistic expectations and prepare them for the changes they will face. A gender‐ and age‐matched laryngectomized patient visitor can contribute to this process. Rehabilitation programmes should incorporate the partner and offer psychosocial support for women following total laryngectomy to return to their former roles in family life, social life and work‐related activities.

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Section: Recommendations For Clinical Practicesupporting

confidence: 86%

Women's perspective on life after total laryngectomy: a qualitative study

Sluis

Kornman

Molen

et al. 2019

Intl J Lang & Comm Disor

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“…Either the disorders related to a reduced prosthetic lifetime or the fistula-related ones previously indicated can influence vocal and communication skills with significant sequelae on the quality of life, inducing the patients to make changes in their behavioral and social sphere [ 12 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the presence of good communication indices is not necessarily related to the degree of satisfaction of the prosthetic treatment and the related socio-emotional consequences [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Voice-Related Quality of Life in Post-Laryngectomy Rehabilitation: Tracheoesophageal Fistula’s Wellness

Cocuzza

Grillo

Ferlito

et al. 2020

IJERPH

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(1) Introduction: Laryngeal cancer is one of the most common types of cancer affecting the upper aerodigestive tract. Despite ensuring good oncological outcome in many locoregionally advanced cases, total laryngectomy is associated with relevant physical and psychological sequelae. Treatment through tracheo-esophageal speech, if promising, can lead to very variable outcomes. Not all laryngectomee patients with vocal prosthesis benefit from the same level of rehabilitation mainly due to the development of prosthetic or fistula related problems. The relating sequelae in some cases are even more decisive in the patient quality of life, having a higher impact than communicational or verbal skills. (2) Material and Methods: A retrospective study was conducted on 63 patients initially enrolled with a history of total laryngectomy and voice rehabilitation, treated at the University Hospital of Catania from 1 January 2010 to 31 December 2018. Quality of life (QoL) evaluation through validated self-administrated questionnaires was performed. (3) Results: The Voice-Related Quality of Life questionnaire revealed significantly better outcomes in both socio-emotional and functional domains of the tracheoesophageal patient group compared to the esophageal group (p = 0.01; p = 0.01, respectively), whereas in the Voice Handicap Index assessment, statistically significant scores were not achieved (p = 0.33). (4) Discussion: The significant differences reported through the V-RQOL and Voice Handicap Index scales in the presence of fistula related problems and device lifetime reduction when compared to the oesophageal speech group have demonstrated, as supported by the literature, a crucial role in the rehabilitative prognosis. (5) Conclusions: The criteria of low resistance to airflow, optimal tracheoesophageal retention, prolonged device life, simple patient maintenance, and comfortable outpatient surgery are the reference standard for obtaining good QoL results, especially over time. Furthermore, the correct phenotyping of the patient based on the main outcomes achieved at clinical follow-up guarantees the primary objective of the identification of a better quality of life.

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“…One of the most important rehabilitation goals after total laryngectomy is voice rehabilitation. To compensate for the loss of voice, patients ideally rehabilitate speech with a voice prosthesis, so called Tracheo-Esophageal Speech (TE-speech) [1][2][3]. If this is not possible, alternative communication methods include esophageal speech, electrolarynx speech, or augmentative alternative communication.…”

Section: Introductionmentioning

confidence: 99%

Multidimensional evaluation of voice outcomes following total laryngectomy: a prospective multicenter cohort study

Sluis¹,

Son²,

Molen³

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose The purpose of this study is to assess the general course of acoustic, patient rated, and clinician-rated voice outcomes from pre-up to 12 months post total laryngectomy. Methods Patients admitted to a total laryngectomy in five participating hospitals in Australia and The Netherlands were included. Assessments took place at pre-, 3 months, 6 months, and 12 months post-surgery. Voice outcomes are evaluated with the Acoustic Voice Quality Index (AVQI), perceptual scales, and patient-reported outcome measures including VHI-10 and EQ-5D-5L. Statistical analyses include descriptive statistics, t tests (pre-to 6 months post-surgery), Linear Mixed Effect models. Results The study included 43 participants. A significant worsening of AVQI is seen from pre-to post-surgery evaluated with t test (p < 0.001). The Linear Mixed Effect model confirmed Time as a significant factor in predicting AVQI score (p ≤ 0.001), as well as perceptual rated voice quality by the clinician (p = 0.015) and patient-reported perceptual rated voice quality (p = 0.002). No statistical significance was found in VHI-10 scores over time. Conclusion Successful TE-speech was achieved in most participants, some had to rely on augmentative alternative communication methods. Patient-reported outcomes indicate acceptance of the condition and sufficient coping in the long term. However, acoustic rated voice quality is abnormal at all post-surgery time-points. AVQI proved to be a useful instrument to evaluate TE-speech. There is a need for validation and determination of cutoff values for VHI-10 and AVQI for use in TE-speech.

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Communication changes with laryngectomy and impact on quality of life: a review

Cited by 43 publications

References 21 publications

Women's perspective on life after total laryngectomy: a qualitative study

Women's perspective on life after total laryngectomy: a qualitative study

Voice-Related Quality of Life in Post-Laryngectomy Rehabilitation: Tracheoesophageal Fistula’s Wellness

Multidimensional evaluation of voice outcomes following total laryngectomy: a prospective multicenter cohort study

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