State of the art: Rehabilitation of speech and swallowing after total laryngectomy

Zenga, Joseph; Goldsmith, Tessa; Bunting, Glenn; Deschler, Daniel G.

doi:10.1016/j.oraloncology.2018.08.023

Cited by 56 publications

(58 citation statements)

References 101 publications

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“…Indeed, Maddox et al showed in a retrospective study, conducted in the US, that, between 1997 and 2008, the rate of TL has dropped (−48%) more than the incidence of LC has dropped (−33%), consistent with the trend toward nonsurgical treatment [44]. In most cases, patients undergoing TL recover satisfactory swallowing function [26,28,45]. Long-term feeding-tube-dependence rates between 5% and 10% are generally reported [28,45,46].…”

Section: Functional Results and Quality Of Life After Total Laryngectomymentioning

confidence: 96%

“…In most cases, patients undergoing TL recover satisfactory swallowing function [26,28,45]. Long-term feeding-tube-dependence rates between 5% and 10% are generally reported [28,45,46]. Better swallowing outcomes are achieved for larynx than for hypopharynx cancer patients [26,29].…”

Section: Functional Results and Quality Of Life After Total Laryngectomymentioning

confidence: 99%

“…With the development of the tracheoesophageal prosthesis (TEP), most laryngectomized patients are able to recover a functional voice [10,45]. Success rates for voice rehabilitation with TEP approximating 85% have been reported by several authors and are superior to those reported with esophageal speech [10,45].…”

Section: Functional Results and Quality Of Life After Total Laryngectomymentioning

confidence: 99%

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Current Role of Total Laryngectomy in the Era of Organ Preservation

Bozec

Culié

Poissonnet

et al. 2020

Cancers

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In this article, we aimed to discuss the role of total laryngectomy (TL) in the management of patients with larynx cancer (LC) in the era of organ preservation. Before the 1990s, TL followed by radiotherapy (RT) was the standard treatment for patients with locally advanced LC. Over the last 30 years, various types of larynx preservation (LP) programs associating induction or concurrent chemotherapy (CT) with RT have been developed, with the aim of treating locally advanced LC patients while preserving the larynx and its functions. Overall, more than two-thirds of patients included in a LP program will not require total laryngectomy (TL) and will preserve a functional larynx. However, despite these advances, the larynx is the only tumor site in the upper aero-digestive tract for which prognosis has not improved during recent decades. Indeed, none of these LP protocols have shown any survival advantage compared to primary radical surgery, and it appears that certain LC patients do not benefit from an LP program. This is the case for patients with T4a LC (extra-laryngeal tumor extension through the thyroid cartilage) or with poor pretreatment laryngeal function and for whom primary TL is still the preferred therapeutic option. Moreover, TL is the standard salvage therapy for patients with recurrent tumor after an LP protocol.

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Section: Functional Results and Quality Of Life After Total Laryngectomymentioning

confidence: 96%

Section: Functional Results and Quality Of Life After Total Laryngectomymentioning

confidence: 99%

Section: Functional Results and Quality Of Life After Total Laryngectomymentioning

confidence: 99%

See 1 more Smart Citation

Current Role of Total Laryngectomy in the Era of Organ Preservation

Bozec

Culié

Poissonnet

et al. 2020

Cancers

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“…, Zenga et al . ). As we move in the direction of health models driven by patient‐centred care, understanding the differential impacts of surgical procedures on subgroups of our patients is important to help improve our care models, patient education and support systems.…”

Section: Introductionmentioning

confidence: 97%

“…Since survival and complication rates improved over the last decades, scholarly attention has shifted towards providing patients with optimal supportive care (Rosa et al 2018, van der Molen et al 2013, Zenga et al 2018). As we move in the direction of health models driven by patient-centred care, understanding the differential impacts of surgical procedures on subgroups of our patients is important to help improve our care models, patient education and support systems.…”

Section: Introductionmentioning

confidence: 99%

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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Relationship between pharyngeal or esophageal reconstruction and esophageal pressure after swallowing

Umezawa

Hokazono

et al. 2022

Cancer Reports

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Background High‐resolution manometry, which measures esophageal luminal pressure changes after swallowing, could shed more light on food‐transport dynamics after pharyngeal/esophageal reconstruction. This prospective cohort study assessed the influence of two head‐and‐neck and esophageal tumor‐resection and reconstruction approaches on esophageal pressure. Methods The cohort consisted of 17 patients who underwent esophageal/pharyngeal resection/reconstruction for cancer and then participated in postoperative high‐resolution manometry. Five healthy controls also underwent manometry for comparison. Results Partial pharyngectomy with patch grafts associated with smooth and continuous esophageal/pharyngeal movement. By contrast, surgery that removed the thoracic esophagus led to complete loss of peristalsis and poor food transport. Conclusions High‐resolution manometry effectively characterized the changes in food‐transport dynamics caused by pharyngeal/esophageal resection/reconstruction. These findings suggest that continuous and smooth movement of the pharynx and esophagus is important for swallowing and high resolution manometry could be useful in patients after pharyngeal/esophageal resection/reconstruction.

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State of the art: Rehabilitation of speech and swallowing after total laryngectomy

Cited by 56 publications

References 101 publications

Current Role of Total Laryngectomy in the Era of Organ Preservation

Current Role of Total Laryngectomy in the Era of Organ Preservation

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

Relationship between pharyngeal or esophageal reconstruction and esophageal pressure after swallowing

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