Voice and swallowing after total laryngectomy

Area of Science:

• Otolaryngology
• Oncology
• Speech-Language Pathology

Background:

• Advanced larynx cancer often leads to voice and swallowing difficulties.
• Total laryngectomy (TL) and chemo/radiotherapy are common treatments for advanced larynx cancer.
• Post-treatment functional deficits significantly impact patient quality of life.

Purpose of the Study:

• To determine the prevalence of voice and swallowing problems in patients post-total laryngectomy (TL).
• To investigate the relationship between these problems and factors like age, time since TL, radiotherapy, and TNM classification.
• To assess voice prosthesis changes and the need for therapeutic interventions after TL.

Main Methods:

• A cohort of 45 patients who underwent total laryngectomy (TL) was included.
• Validated questionnaires, including the Sydney Swallow Questionnaire and the Voice Handicap Index-T, were administered.
• Statistical analysis was performed to correlate symptoms with demographic and clinical factors.

Main Results:

• A high incidence of swallowing problems (89%) and moderate-to-severe voice handicap (66%) was reported post-TL.
• A significant correlation was found between dysphagia and voice problems (r_s = 0.67, p ≤ 0.01).
• Over 60% of patients required additional therapeutic interventions for voice and/or swallowing issues.

Conclusions:

• Voice and swallowing problems are highly prevalent after total laryngectomy (TL).
• Preoperative assessment and patient counseling regarding these potential issues are crucial.
• Optimizing post-operative rehabilitation strategies is essential for improving functional outcomes in advanced larynx cancer patients.