Evaluation of voice by patients and close relatives following different laryngeal cancer treatments

Abstract

The purpose of this study was to assess perception of life style change among laryngeal cancer patients. Seventy-five patients (total laryngectomy 35, supraglottic laryngectomy 15, hemilaryngectomy 12, radiotherapy eight, laser cordectomy five) and close relatives responded to a questionnaire and interview eliciting perception of: 1) posttreatment voice quality; 2) side effects of treatment vocationally and socially; and 3) degree of vocal or communicative change associated with vocational or social change. Whereas 43% of the patients reported vocational change and 37% reported social change, 88% expressed satisfaction with their posttreatment voices. This may have been due to the perceptions of the relatives, who generally had a more positive view of the patients' voices. Although laryngeal cancer had an impact on patient life style, patients seldom related this to vocal dysfunction.

Differential Modes of Alaryngeal Communication and Long-Term Voice Outcomes following Pharyngolaryngectomy and Laryngectomy

“…The low levels of communication disability and handicap reported by the patients in the current study are consistent with previous literature [16,21]. The findings revealed that the majority of patients in both groups reported their pseudovoice to be effective in certain situations and most patients reported self-confidence and the ability to achieve some forms of social integration in their daily life.…”

“…This positive result could largely be attributed to effective coping and adjustment strategies employed by these patients to adjust to their altered communication mode. It has been suggested that the extent of communication disability and handicap can change longitudinally with time, as patients gradually adjust to the experience of having and surviving laryngeal cancer [21]. Considering the fact that the current data is related to patients who were at a minimum of 1 year following surgery, such long-term adjustments and acceptance may similarly be reflected in the present group of patients.…”

The treatment of early laryngeal cancers (T1–T2 N0): surgery or irradiation?

“…Other authors have also demonstrated poor voice quality after endoscopic laser treatment, 34,35 whereas Lehman et al 36 and Schuller et al 37 reported that their patients subjectively assessed their voices as near normal after radiotherapy. The finding of better voice quality after radiotherapy compared with endoscopic laser treatment has been confirmed by other authors.…”

Quality of life measurements of speech in the head and neck cancer patient population

“…It is possible that society in general has difficulty culling out vocal quality from intelligibility, and that impaired voice quality detracts from their ability to understand the message that is being communicated. Therefore, the question remains as to whether the patients' evaluations are more reflective of reality outside the clinical setting or whether they have a more stringent internal standard not shared by those around them (as suggested by Schuller et al's 1990 findings 16 ). An important finding of this study was the need for appropriate wording of items and responses designed to collect patient-reported data.…”

“…It is possible that patients' judgments are more reflective of society in general than SLPs' judgments, which are based on limited observation in the clinical setting. A 1990 study by Schuller et al, 16 however, indicated that patients' ratings of their voice were often lower than ratings provided by their relatives; this finding calls into question whether patients' assessments reflect the general population of untrained listeners or their own personal experiences or biases.…”