[Psychosomatic analysis of laryngectomized patients]

The psychosocial influences of laryngectomy were evaluated in patients with head and neck cancer. Five patients who had indications for surgery, refused laryngectomy. They preferred their occupational activities and pleasure in their social lives to losing their voices. 'Mourning work' is a psychological technical term and represents a psychological process that is set in train by the loss of a loved object, and the mourning work stage in terms of speech loss was one of denial in these subjects. Forty-three laryngectomized patients were analyzed as to postoperative daily life and mental state. The relationship between the QOL (quality of life) of laryngectomized patients and the degree of depression were also investigated on a Self-rating Depression Scale. Only 21.6% of patients could continue the same work postoperatively, while 44.8% answered that their postoperative mental state tended to be more passive than the preoperative state. The patients who regretted having a laryngectomy showed significant depression in comparison with the patients who accepted laryngectomy. It seemed that patients who regretted having a laryngectomy suffered from 'pathological' mourning. Thus, we must assist those undergoing laryngectomy in transferring from 'pathological' mourning to 'healthy' mourning.