Tracheoesophageal Prosthesis Use Is Associated With Improved Overall Quality of Life in Veterans With Laryngeal Cancer

Patel, Ramya S.; Mohr, T; Hartman, Christine; Stach, Carol B.; Sikora, Andrew G.; Zevallos, José P.; Sandulache, Vlad C.

doi:10.1177/0003489418772067

Cited by 15 publications

(14 citation statements)

References 19 publications

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“…Learning appropriate useful coping strategies is important for dealing with the new situation and affects the quality of life [100]. Speech rehabilitation should be carried out with a voice prosthesis whenever possible [109] and is crucial for the patient's quality of life [14]. It is problematic that the reduced quality of life due to functional damage and mental stress does not seem to improve with time, even after 10 years [107].…”

Section: Quality Of Life After Total Laryngectomymentioning

confidence: 99%

Total Laryngectomy—Still Cutting-Edge?

Hoffmann

2021

Cancers

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Surgical removal of the larynx (total laryngectomy) offers a curative approach to patients with advanced laryngeal and hypopharyngeal (squamous cell) cancer without distant metastases. Particularly in T4a carcinoma, laryngectomy seems prognostically superior to primary radio(chemo)therapy. Further relevant indications for laryngectomy include massive laryngeal dysfunction associated with aspiration and recurrence after radio(chemo)therapy, resulting in salvage surgery. The surgical procedure including neck dissection is highly standardised and safe. The resulting aphonia can be compensated by functional rehabilitation (e.g., voice prosthesis) associated with a significant quality of life improvement. This article presents an overview of indications, preoperative diagnostics, surgical procedures, including new developments (robotics), possible complications, the choice of adjuvant treatment, alternative therapeutic approaches, rehabilitation and prognosis. In summary, total laryngectomy still represents a relevant surgical procedure in modern head and neck oncology.

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Section: Quality Of Life After Total Laryngectomymentioning

confidence: 99%

Total Laryngectomy—Still Cutting-Edge?

Hoffmann

2021

Cancers

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“…In both methods of voice rehabilitation, an internal substitute sound source is produced in the pharyngoesophageal segment. Many studies have reported that tracheoesophageal speech (TES) provides a good quality of speech and represents an excellent means of communication 11–13. However, it is difficult to determine the most effective rehabilitation method in terms of both objective good quality of voice and greater satisfaction for the patient.…”

Section: Introductionmentioning

confidence: 99%

“…However, it is difficult to determine the most effective rehabilitation method in terms of both objective good quality of voice and greater satisfaction for the patient. Few studies12,13 have considered the correlation between quality of voice, assessed by using acoustic analysis, and patients’ perception of their rehabilitated voice. Therefore, this study aimed to determine the acoustic quality of the rehabilitated voice, achieved with ES and TES, and its impacts on patients’ perceptions of their quality of life.…”

Section: Introductionmentioning

confidence: 99%

<p>Verbal performance of total laryngectomized patients rehabilitated with esophageal speech and tracheoesophageal speech: impacts on patient quality of life</p>

Allegra¹,

Mantia

Bianco³

et al. 2019

PRBM

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Introduction Total laryngectomy has important psychophysical and social consequences for patients’ quality of life because of the functional changes resulting from the removal of the larynx. Voice deprivation is perhaps the most relevant limiting factor in social relationships, increasing feelings of solitude and tending to drive individuals into social isolation. Multiple voice rehabilitation methods after total laryngectomy are available. This study aimed to determine the acoustic quality of the rehabilitated voice achieved with esophageal speech (ES) and tracheoesophageal speech (TES), and acoustic quality impacts on patients’ perceptions of their quality of life. Materials and methods The patient inclusion criterion was the completion of a speech rehabilitation course with ES or TES at least 6 months after total laryngectomy. The voice acoustic analysis was carried out automatically by using the Multidimensional Voice Program. The following parameters were extracted: fundamental frequency (F0), Jitter% (Jitt), Shimmer% (Shim), and noise-to-harmonic ratio (NHR). Subjective voice evaluation was performed by using the following questionnaires: Voice Handicap Index (VHI), Voice-related Quality of Life (V-RQOL), and Voice Performance Questionnaire (VPQ). Results The acoustic analysis showed a difference between ES and TES patients on all acoustic parameters; this difference was significant for F0 (133.09±2.4 and 119±3.3, respectively; p <0.001), NHR (0.43±0.21 and 0.31±0.14, respectively; p =0.02), and maximum phonation time (2.02±038 s and 10.64±0.28 s, respectively; p =0.01. Regarding patient-related outcomes, TES correlated with better total scores compared with ES; however, the differences in the total scores on the VHI ( p =0.09), V-RQOL ( p =0.39), and VPQ ( p =0.52) were not statistically significant. Conclusion The rehabilitation of laryngectomized patients must be addressed by a multidisciplinary team that considers the personalities, personal needs, and relational conditions of individual patients in order to determine and apply the phonatory rehabilitation method most suitable for achieving a better quality of life.

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“…This is the case for major enlargements of the tracheo-esophageal fistulae that occur in less than 5% of patients but can require highly complex surgical reconstruction [52,53]. However, with an experienced multidisciplinary team, the advantages of using TEP far outweigh their drawbacks [50,54]. Currently, there is no consensus that exists with regard to the timing of performing TEP, and the decision to perform a primary (at time of TL) or secondary TEP has mostly been based on physician preference [10,55].…”

Section: Functional Results and Quality Of Life After Total Laryngectomymentioning

confidence: 99%

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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Tracheoesophageal Prosthesis Use Is Associated With Improved Overall Quality of Life in Veterans With Laryngeal Cancer

Cited by 15 publications

References 19 publications

Total Laryngectomy—Still Cutting-Edge?

Total Laryngectomy—Still Cutting-Edge?

<p>Verbal performance of total laryngectomized patients rehabilitated with esophageal speech and tracheoesophageal speech: impacts on patient quality of life</p>

Current Role of Total Laryngectomy in the Era of Organ Preservation

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