The influence of vocal rehabilitation methods on communication in patients with total laryngectomy

Abstract

BACKGROUND. Considering the problematic social integration after total laryngectomy, evaluation of communicational aptitudes of patients after the surgical intervention is necessary in order to optimize their vocal rehabilitation process. MATERIAL AND METHODS. A prospective clinical study was conducted on 24 randomly selected patients of the Otolaryngology Clinic of Targu Mures County Emergency Clinical Hospital that underwent total laryngectomy. We adapted and implemented the questionnaire for Self-Evaluation of Communication Experiences after Laryngectomy – SECEL. Three groups of patients were created: the first containing those with voice prosthesis, the second those using electrolarynx and esophageal voice, and the third with no rehabilitation. We used the Kruskal-Wallis test for the statistical analysis of the results. RESULTS. The mean age of the patients included in our study group was 63 years (+/− 7.56 SD). 95.83% of the participants were male. 79.16% were married. The majority (87.50%) of patients were retired. In 75% of cases, 0 to 5 years have passed since the surgery. 75% reported diminished communication after surgery. The test used to determine if significant differences were present between the examined groups showed a p-value of 0.1329 (total scores), p-value of 0.3244 (the first score of SECEL), p-value = 0.6004 (the second score of SECEL) and a p-value of 0.0613 (the third score of SECEL). Given that p was higher than 0.05, the null hypotheses could not be rejected. The patients who underwent rehabilitation by tracheoesophageal prosthesis showed the best results in all tested categories. CONCLUSION. The SECEL questionnaire adapted in Romanian language could be used as a valid screening instrument in order to improve voice rehabilitation, but it needs further testing.