Laryngectomy: beyond loss of voice--caring for the patient as a whole

For patients with laryngeal cancer, rehabilitation following laryngectomy may be difficult. However, significant variability in coping skills and adaptation of this patient population exists. Healthcare providers commonly perceive disfigurement, alteration in function (i.e., loss of natural voice), and disease control as the most relevant issues in the postoperative period, yet patients and their families may not share these same priorities. Management of physical symptoms, social reintegration, participation in enjoyed activities, and vocational issues following laryngectomy may present significant barriers to achieving optimal quality of life. Comprehensive preoperative counseling that includes patients and their caregivers is an important aspect of preparation for surgery. This review examines dimensions of adaptation, rehabilitation, and quality of life following laryngectomy.