Olfaction and gustation abilities after a total laryngectomy

Abstract Background. A laryngectomy affects many of a patient’s functions. Besides speech and respiratory-tract problems, olfaction and gustation problems can also have an influence on the quality of life. The aim of this study was to find out how often various nasal problems and decreased gustation appear after a laryngectomy. Patients and methods. One hundred and five laryngectomized patients (9 women, 96 men, aged 45-88 years), treated in two tertiary centers, were included in the study. They completed a questionnaire about various nasal problems, olfactory and gustatory capabilities, possible allergies and irritants in their environment, and the impact of the nasal and gustation problems on their quality of life. Results. Olfaction was impaired in 51.4%, and was even not possible in 30.5%, of patients. Decreased gustation abilities were reported in 26.7%, and dysgeusia in 11.4%, of patients. Almost 21% of patients were bothered by an impaired gustatory ability and 50.5% of patients were affected by their loss of olfaction. Frequent nasal discharge was reported in 20%, frequent sneezing in 58.1%, and nasal itching in 33.3% of the laryngectomized patients. There were no correlations between the age and the olfaction and gustation abilities and between the allergy and the nasal symptoms, whereas the correlation between olfaction and gustation appeared significant (p=0.025). Conclusions. Various nasal and gustatory problems were reported in more than 80% of laryngectomized patients. The olfaction and gustation abilities are connected and have a substantial impact on the quality of life. Like in the case of speech, the rehabilitation of olfaction is also necessary in all laryngectomized patients and must take place soon after the completion of the treatment.

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Nasal disease and quality of life in athletes

The Journal of Laryngology & Otology ◽

10.1017/s0022215118001408 ◽

2018 ◽

Vol 132 (9) ◽

pp. 812-815

Author(s):

A C Walker ◽

P Surda ◽

M Rossiter ◽

S A Little

Keyword(s):

Quality Of Life ◽

Respiratory Tract ◽

Respiratory Tract Infections ◽

Upper Respiratory Tract Infections ◽

Upper Respiratory Tract ◽

Nasal Symptoms ◽

Nasal Disease ◽

Upper Respiratory ◽

Tract Infections

AbstractObjectivesNasal disease imposes a significant disease burden upon the individual in the general population, but is relatively under studied in athletes. This study sought to define the frequency of nasal symptoms in the active population, and to quantify the impact of these symptoms on quality of life and on the frequency of upper respiratory tract infections.ResultsA total of 296 participants completed the study (246 athletes and 50 sedentary controls). Nasal symptoms were significantly more frequent in the active group than in the sedentary controls (70 per cent vs 52 per cent). Upper respiratory tract infections were significantly more common in athletes with regular nasal symptoms than in athletes without nasal symptoms. Quality-of-life scores, as measured by the 22-item Sino-Nasal Outcome Test, were significantly worse in athletes with regular nasal symptoms.ConclusionThis study suggests that regular exercise is associated with a significant increase in the prevalence of troubling nasal symptoms, and nasal symptoms in athletes are associated with increased susceptibility to upper respiratory tract infections. Quality of life was negatively affected, confirming the importance of nasal health to athlete welfare.

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The impact of allergic rhinitis on symptoms, and quality of life using the new criterion of ARIA severity classification

Rhinology Journal ◽

10.4193/rhino11.071 ◽

2012 ◽

Vol 50 (1) ◽

pp. 33-36

Author(s):

Antonio Valero ◽

Rosa Munoz-Cano ◽

Joaquin Sastre ◽

Ana M. Navarro ◽

Enrique Marti-Guadano ◽

...

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Common Disease ◽

Life Questionnaire ◽

Nasal Symptoms ◽

Severity Classification ◽

New Criterion ◽

The Impact ◽

Severity Criterion

Introduction: Allergic rhinitis (AR) is a common disease with major socieconomic burden and a significant impact on quality of life. Objective: The objective of the study was to assess the impact of AR severity, using the modified ARIA (m-ARIA) severity criterion in order to discriminate among moderate and severe AR, in symptoms and quality of life assessed with the questionnaire ESPRINT-15. Methods: The specific quality of life questionnaire (ESPRINT-15) was applied in over thousand untreated RA patients. Severity was evaluated by the m-ARIA classification, which categorizes AR as mild, moderate, and severe. Nasal symptoms were evaluated by using categorized (none, low, middle, and high) Total Four Symptom Score (T4SS). Results: Using the m-ARIA severity classification, significant differences in quality of life, both global score and specific domains, and categorized T4SS were found among the AR severity groups. Conclusion: Modified ARIA severity classification in mild, moderate, and severe allergic rhinitis clearly discriminates the impact of AR in all domains of quality of life and categorized symptom`s score.

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Evidence-Based Minireview: Abnormal uterine bleeding in users of rivaroxaban and apixaban

Hematology ◽

10.1182/hematology.2020000166 ◽

2020 ◽

Vol 2020 (1) ◽

pp. 538-541

Author(s):

Amanda E. Jacobson-Kelly ◽

Bethany T. Samuelson Bannow

Keyword(s):

Quality Of Life ◽

Observational Studies ◽

Oral Anticoagulants ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Evidence Based ◽

Substantial Impact ◽

Menstruating Women ◽

The Impact

Abstract Up to two-thirds of menstruating women experience abnormal uterine bleeding (AUB) when treated with oral anticoagulants. However, the true prevalence of AUB for specific agents remains uncertain, as many of these episodes, while interfering significantly with quality of life and overall health, are not captured by definitions of major bleeding (MB) or clinically relevant nonmajor bleeding (CRNMB) used in clinical trials. A 2017 systematic review determined that women taking rivaroxaban, but not edoxaban or apixaban, had a twofold higher risk of AUB than women taking warfarin. Since then, new data have become available from extension trials, cancer-associated venous thromboembolism trials, pediatric trials, and a few observational studies specifically examining AUB as an outcome. Reported rates of uterine CRNMB were low (around 1%) and similar for rivaroxaban and apixaban in all these studies, and no episodes of uterine bleeding meeting MB criteria were reported. Rates of AUB not meeting MB or CRNMB criteria were much higher, affecting up to 50% of women on rivaroxaban. Only 1 such study included women on apixaban, and no AUB was reported. In pediatric trials, 19% of girls experienced menorrhagia when treated with rivaroxaban. In conclusion, rates of uterine MB and CRNMB were low in all studies, but rates of other types of AUB not meeting these criteria ranged from 15.8% to 50%. We conclude that AUB is underreported due to the limitations of MB/CRNMB criteria despite its substantial impact on quality of life. We urge future investigators to include broader definitions of AUB to better capture the impact of this outcome in menstruating women treated with oral anticoagulants.

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The impact of allergic rhinitis on symptoms, and quality of life using the new criterion of ARIA severity classification

Rhinology Journal ◽

10.4193/rhino.11.071 ◽

2012 ◽

Vol 50 (1) ◽

pp. 33-36

Author(s):

Antonio Valero ◽

Rosa Munoz-Cano ◽

Joaquin Sastre ◽

Ana M. Navarro ◽

Enrique Marti-Guadano ◽

...

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Common Disease ◽

Life Questionnaire ◽

Nasal Symptoms ◽

Severity Classification ◽

New Criterion ◽

The Impact ◽

Severity Criterion

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Is there a difference in quality of life, comparing summer and winter, in patients who have undergone total laryngectomy?

The Journal of Laryngology & Otology ◽

10.1017/s0022215107000357 ◽

2007 ◽

Vol 122 (9) ◽

pp. 967-971

Author(s):

F C Van Wyk ◽

F Vaz ◽

M Harries ◽

J Weighill

Keyword(s):

Quality Of Life ◽

Total Laryngectomy ◽

Cross Sectional Study ◽

Short Term ◽

Cross Sectional ◽

European Organization ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

The Impact

AbstractIntroduction:Several studies have implied that patients' quality of life stabilises six months after undergoing total laryngectomy. However, these studies may well have overlooked persistent short term variations in patients' quality of life. The aim of this study was to assess the impact of seasonal change (i.e. summervswinter) on the quality of life of patients following total laryngectomy.Methods:A prospective, cross-sectional study of recurrence-free laryngectomy patients was performed, using the European Organization for Research and Treatment of Cancer (version three) QLQ-C30 questionnaires (EORTC QLQ-C30), during January 2004 (i.e. winter), August 2004 (summer) and January 2005 (winter).Results:Thirty-six patients were entered into the study. The response rate was 70.3 per cent. Patient's time elapsed since surgery varied from six months to 12 years. In all questionnaire domains, responses seemed remarkably consistent over time.Conclusion:No statistically significant differences were found between summer and winter scores in all the domains analysed by the EORTC QLQ-C30.

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Abstract 334: Listening to a Diversity of Patient Voices To Design a High-Quality Peripheral Arterial Disease Registry Focusing on Patient-Centered Outcomes

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.6.suppl_1.a334 ◽

2013 ◽

Vol 6 (suppl_1) ◽

Author(s):

Kim Smolderen ◽

Carole Decker ◽

Brian Garavalia ◽

Kathryn M Scott ◽

Emily G Chhatriwalla ◽

...

Keyword(s):

Quality Of Life ◽

African American ◽

Health Status ◽

Peripheral Arterial Disease ◽

Study Design ◽

Arterial Disease ◽

Substantial Impact ◽

Peripheral Arterial ◽

The Impact

Background: While peripheral arterial disease (PAD) greatly impacts patients’ health status (symptoms, function and quality of life) and risk for cardiovascular events, no prospective studies have examined the impact of treatments in routine clinical practice on these outcomes. To create a future, multi-center PAD registry focused on health status outcomes over time, we prospectively engaged PAD patients in a qualitative study to explore the optimal study design. Methods: In the PORTRAIT Phase I study, a multidisciplinary team (nurse, anthropologist, psychologist) conducted 6 focus groups in 2 US sites (May-Dec 2012). Groups were organized by their demographic characteristics: females, males, elderly mixed females/males, African-American females, African-American males, and Hispanic mixed females/males involving 22 PAD patients. Sessions were recorded, transcribed and coded using descriptive content analysis until thematic saturation occurred. Input was solicited on the patients’ experience with PAD (diagnosis, treatment, life-style impact), preferred outcomes, topics to measure, and study organization. Results: Participants’ ages ranged from 51-86 and included 12 females, 8 African Americans, and 3 Hispanics. Patients had undergone percutaneous (n=7), surgical (n=2), both (n=3) or neither (n=10) types of revascularization. Three main themes emerged: 1) PAD symptom unawareness in both patients and doctors caused significant delays in receiving both a diagnosis and treatment (e.g. a 56yo female: “He said you basically have no blood flow in either leg. If you would have waited another week, you would have lost both of your legs.”). 2) Patients reported substantial impact of PAD on daily functioning and prioritized symptom relief, improved walking and quality of life as key outcomes (e.g. a 52yo male said: “And then the improvement in quality of life¼ There was just no question about whether to do it [surgery]¼”). And 3) Inadequate patient-physician communication and information deficiency about treatment options and outcomes were frequently reported (e.g. an 85yo female said: “No, there was never any idea of what I should do or why I shouldn’t do it. Just if you want some stents, we’ll put them in.”). With regards to optimal study design, facilitators of study participation included encouragement by their doctor to participate, and phone follow-up, while barriers included the cost of transportation and time taken off by family member (e.g. an 82yo female stated: “My daughter does not work on Fridays, but doctors don’t want to give appointments on Fridays.”). Conclusion: Insights from a diverse sampling of PAD patients can guide registry development by defining what outcomes PAD patients value most, how best to develop the screening and research design, and how to be maximally inclusive of a wide variety of PAD patients.

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Quality of Life after Surgical Treatment of Cancer of the Larynx

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949510401003 ◽

1995 ◽

Vol 104 (10) ◽

pp. 763-769 ◽

Cited By ~ 93

Author(s):

Lawrence W. DeSanto ◽

Kerry D. Olsen ◽

Daniel E. Rohe ◽

William C. Perry ◽

Robert L. Keith

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Psychosocial Adjustment ◽

Total Laryngectomy ◽

Negative Impact ◽

Partial Laryngectomy ◽

Partial Operation ◽

As Stress ◽

The Impact

The purpose of the study was to assess the quality of life of patients after surgical treatment for cancer of the larynx. Three groups of patients were identified according to surgical treatment: total laryngectomy, 111 patients; near-total laryngectomy, 38 patients; and partial laryngectomy, 23 patients. The impact of successful surgical treatment on their life roles was analyzed in terms of work, activities, familial and spousal relationships, sexuality, and psychologic features such as stress and anxiety. Two questionnaires were used: the Psychosocial Adjustment to Illness Scale (PAIS) and the Mayo Clinic Postlaryngectomy Questionnaire. With the PAIS questionnaire, no difference was found in role adjustment between the total laryngectomy and near-total laryngectomy groups, with one exception. In the work domain, the total laryngectomy patients who were working had better adjustment than the near-total laryngectomy patients. The overall adjustment of both groups was less favorable than that of a comparison group of patients with nonlaryngeal cancer. The patients who had the classic conservation operations adjusted in all domains more favorably than the patients with permanent tracheostomas. The partial operation patients adjusted better than the nonlaryngeal cancer patients. We conclude that the stoma has a negative impact on adjustment postoperatively and that it may have a more serious impact on life adjustment than voice alteration. Further investigation and standardization of measurement tools are needed.

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Combined analysis of 3 cross-sectional surveys of pain in 14 countries in Europe, the Americas, Australia, and Asia: impact on physical and emotional aspects and quality of life

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0003 ◽

2020 ◽

Vol 20 (3) ◽

pp. 575-589

Author(s):

Martina Hagen ◽

Taara Madhavan ◽

John Bell

Keyword(s):

Quality Of Life ◽

Assessment Tool ◽

Pain Treatment ◽

Cross Sectional ◽

Substantial Impact ◽

Combined Analysis ◽

Emotional Aspects ◽

United States Mexico ◽

The Impact

AbstractBackground and aimsRecognition of the biopsychosocial aspects of pain is important for a true understanding of the burden of pain and the necessity of pain management. Biopsychosocial aspects of pain may differ between countries and cultures. Market research methods can be well suited and effective for assessing patient perspectives of pain and biopsychosocial differences. We conducted and combined 3 cross-sectional, international surveys to document the impact of pain on physical and emotional aspects of life, as well as quality of life (QOL).MethodsOnline panelists from 24 countries took part in our surveys in 2014, 2016, and 2017. Fourteen countries (Australia, Brazil, Canada, China, Germany, Italy, Japan, Poland, Russia, United Kingdom, United States, Mexico, Sweden, Saudi Arabia) contributed data in all 3 surveys and comprise the analysis population. A Global Pain Index (GPI) was constructed using 8 questions in 3 categories: Physical (frequency, duration, intensity of pain), Emotional (anxiety, impact on self-esteem, happiness), and Impact on QOL and ability to enjoy life. Each item was scored as the percentage of respondents meeting a prespecified threshold indicative of a substantial pain impact. Scores for the items within each category were averaged to obtain a category score, category scores were averaged to obtain a total score for each survey, and total scores from each survey were averaged to obtain a final combined score. Scores were assessed for the overall population, by individual countries, by age and gender, and by self-identified pain-treatment status (treat immediately, wait, never treat).ResultsOf the 50,952 adult respondents, 28,861 (56.6%) had ever experienced musculoskeletal pain; 50% of those with pain had pain with a multifaceted impact based on the GPI (Physical: 51%; Emotional: 40%; QOL Impact: 59%). Russia (57%) and Poland (56%) had the highest scores; Mexico (46%), Germany (47%), and Japan (47%) had the lowest. GPI score was higher in women (52%) than men (48%), and initially increased with age through age 54 (18‒24 years: 45%; 25‒34 years: 52%; 35‒44 years: 53%; 45‒54 years: 54%), after which it decreased again (55‒64 years: 51%; ≥65 years: 45%). A majority (65%) of respondents wait to treat their pain, whereas 21% treat their pain immediately and 14% never treat pain. The most common reason for waiting (asked in survey 3 only) was to avoid taking medication.ConclusionsIn this combined analysis of 3 international surveys using a novel biopsychosocial pain assessment tool, pain had a substantial impact on ~50% of respondents’ lives, spanning physical (51%), emotional (40%), and QOL effects (59%). Despite the substantial impact, a majority of patients tried to avoid treating their pain.ImplicationsClinicians should take a biopsychosocial approach to pain by asking patients not only about the presence and severity of pain, but the extent to which it affects various aspects of their lives and daily functioning. Patients may also need education about the efficacy and safety of available treatments for self-management of pain. The GPI may be a useful new tool for future studies of the biopsychosocial effects of pain in large populations.

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The impact of symptoms on health-related quality of life in elderly pre-dialysis patients: effect and importance in the EQUAL study

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfy167 ◽

2018 ◽

Vol 34 (10) ◽

pp. 1707-1715 ◽

Cited By ~ 3

Author(s):

Pauline W M Voskamp ◽

Merel van Diepen ◽

Marie Evans ◽

Fergus J Caskey ◽

Claudia Torino ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Decision Making ◽

Dialysis Patients ◽

Symptom Index ◽

Substantial Impact ◽

Stage 4 ◽

Ckd Stage ◽

The Impact

Abstract Background Quality of life (QoL) is an important outcome in chronic kidney disease (CKD). Patients feel that symptoms are an important determinant of QoL. However, this relation is unknown. The aims of this study were to investigate the impact of the number and severity of symptoms on QoL in elderly pre-dialysis patients, assessed by both the effect of symptoms and their importance relative to kidney function, and other clinical variables on QoL. Methods The European Quality study (EQUAL study) is an ongoing European prospective follow-up study in late Stage 4/5 CKD patients aged ≥65 years. We used patients included between March 2012 and December 2015. Patients scored their symptoms with the Dialysis Symptom Index, and QoL with the research and development-36 (RAND-36) item Health Survey (RAND-36). The RAND-36 results in a physical component summary (PCS) and a mental component summary (MCS). We used linear regression to estimate the relation between symptoms and QoL at baseline and after 6 months, and to calculate the variance in QoL explained by symptoms. Results The baseline questionnaire was filled in by 1079 (73%) patients (median age 75 years, 66% male, 98% Caucasian), and the follow up questionnaire by 627 (42%) patients. At baseline, every additional symptom changed MCS with −0.81 [95% confidence interval (CI): −0.91 to −0.71] and PCS with −0.50 (95% CI: −0.62 to −0.39). In univariable analyses, number of symptoms explained 22% of MCS variance and 11% of PCS variance, whereas estimated glomerular filtration rate only explained 1%. Conclusions In elderly CKD Stage 4/5 patients, symptoms have a substantial impact on QoL. This indicates symptoms should have a more prominent role in clinical decision-making.

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Can laryngectomees smell? Considerations regarding olfactory rehabilitation following total laryngectomy

The Journal of Laryngology & Otology ◽

10.1017/s0022215109992489 ◽

2010 ◽

Vol 124 (4) ◽

pp. 361-365 ◽

Cited By ~ 6

Author(s):

J W Moor ◽

A Rafferty ◽

S Sood

Keyword(s):

Quality Of Life ◽

Respiratory Tract ◽

Total Laryngectomy ◽

Lower Respiratory Tract ◽

Olfactory Function ◽

Advanced Malignancy ◽

Olfactory Loss ◽

Life Issues ◽

Rehabilitation Assessment

AbstractTotal laryngectomy is performed for patients with advanced malignancy of the larynx and pharynx, and disconnects the nose and mouth from the lower respiratory tract. Rehabilitation of olfactory function in these patients is often neglected, despite recognition that anosmia and hyposmia are common and can readily be addressed. This paper reviews the literature concerning olfactory loss post-laryngectomy, methods of olfactory rehabilitation, assessment of olfactory function and quality of life issues.

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