scholarly journals Surgical Outcome and Quality of Life After Total Laryngectomy in Advanced Laryngeal Cancer- A Study in Combined Military Hospital, Dhaka

2021 ◽  
Vol 27 (1) ◽  
pp. 5-11
Author(s):  
Muhammad Ali Azad ◽  
Belayat H Siddiquee ◽  
AKM Asaduzzaman ◽  
Faisal Bin Mohsin ◽  
Mohammad Abul Hasnat
Keyword(s):  
Quality Of Life ◽  
Laryngeal Cancer ◽  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Military Hospital ◽  
Voice Rehabilitation ◽  
Retrospective Clinical Study ◽  
Cartilage Erosion ◽  
Oncology Unit

Introduction: Total laryngectomy is the gold standard treatment for advanced laryngeal cancer. Sacrifice of voice is one of the most important shortcomings of the procedure. Possibility of achieving good quality voice is greater with prosthesis compared to other method. Post laryngectomy voice rehabilitation with prosthesis yield excellent outcome in most of the cases. Swallowing, pulmonary and olfactory rehabilitation should be managed by multidisciplinary team for better quality of life (QoL). Objectives: The purpose of this study was to observe the outcomes of voice, swallowing pulmonary and olfactory rehabilitation and QoL following total laryngectomy. Methods: This cross sectional retrospective clinical study was conducted at the Head & Neck Oncology Unit, Combined Military Hospital (CMH), Dhaka. Total 57 candidates were selected. Diagnosis was done by thorough clinical examination, Fibre Optic Laryngoscopy. Contrast Enhanced Computed Tomography (CECT) scan of neck was done except few cases where MRI of neck was done for subtle cartilage erosion was suspected. Examination under anaesthesia, direct larangoscopy and biopsy was done for every cases. Candidates were post chemo-radiated/ radiated biopsy proven recurrent cases, clinically nonfunctional larynx with aspiration and radiologically evident of cartilage erosion. In all cases artificial voice prosthesis was used. All the laryngectomees underwent voice, swallowing, pulmonary and olfactory rehabilitation in laryngectomy club of head & neck oncology unit, CMH Dhaka for a period of 3 months as per standard protocol. Results: Among the 57 patients 42 of them are using voice prosthesis without any complications till to date. Voice rehabilitation started after wound healing & developed meaningful voice in around 6 weeks. Satisfactory speech & voice outcomes were observed near about 3 months. Voice quality was assessed by multivariate statistical analysis. Excellent voice was observed for 38 patients, good voice for 12 patients, fair voice for 05 patients and poor voice for 02 patients. Troubleshooting like mycotic infection developed in 6 patients which was managed by anti-fungal medication with regular appropriate cleaning, Pharyngocutaneous fistula developed in 5 patients, 3 healed later by pressure dressing and anticholinergic & 1 required exploration and flap reconstruction, 01 developed recurrent stomal stenosis which managed surgically by Y-V advancement. Prosthesis expelled out in 3 cases. 02 cases developed dysphagia due to tonicity of pharyngoesophageal (PE) segment & managed by botox injection. Significantly better voice & swallowing were reported by patients undergone laryngectomy alone in comparison with patients receiving adjuvant radiotherapy & patient undergoing salvage laryngectomy. Conclusion: Awareness should be developed as sacrifice of voice box is no more a permanent comorbidity of total laryngectomy. Excellent voice can be developed by insertion of voice prosthesis as well as swallowing pulmonary and olfactory rehabilitation following laryngectomy for better of QoL. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 5-11

Systematic Review of The Outcome of Different Modalities of Voice Rehabilitation Following Total Laryngectomy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Adly Mohamed ◽  
Tarek Abdel hamid Hamdy ◽  
Anas Mohamed Askoura ◽  
Mohamed Samir Ahmed Kamal Mohamed Ghaly
Keyword(s):  
Quality Of Life ◽  
Total Laryngectomy ◽  
Voice Rehabilitation ◽  
Speech Impairment ◽  
Advantages And Disadvantages ◽  
Artificial Larynx ◽  
Oncologic Patients ◽  
Prisma Statement ◽  
Single Method

Abstract Background Speech impairment occurs in 34-70% of head and neck oncologic patients. Management of this impairment is through surgical and nonsurgical methods. Progress in voice rehabilitation following total laryngectomy has over the last 30 years, made an enormous difference in the whole concept of the management of laryngeal cancers. Objective To explore the outcome of different options of voice rehabilitation after total laryngectomy and the advantages and disadvantages of each method in order to improve the quality of life of laryngectomized patients and the suggestion of future directions for research. Patients and Methods The Aim of this work is to provide cumulative data about the efficacy and safety of the outcome of different modalities of voice rehabilitation following total laryngectomy. This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Metaanalyses (PRISMA) statement guidelines. Results Voice rehabilitation is one of the most important determinants of the quality of life after total laryngectomy. Recent advances in prosthetic voice devices have made such devices the gold standard for voice rehabilitation. They are thus preferred and used more often than old methods (esophageal speech and artificial larynx). Conclusion Although, no single method is considered to be the best for every patient, the tracheoesophageal puncture has become the most preferred method in the past decade. But it is not always possible in all patients, the results of this study indicate that ES, when achievable, is a viable option that should be considered by surgeons when making intervention decisions on patients, and should be revived when indicated. But we need much more studies.

The effects of indwelling voice prosthesis on the quality of life, depressive symptoms, and self-esteem in patients with total laryngectomy

2014 ◽  
Vol 272 (11) ◽  
pp. 3431-3437 ◽  
Author(s):  
Beldan Polat ◽  
Kadir Serkan Orhan ◽  
Mustafa Caner Kesimli ◽  
Yasemin Gorgulu ◽  
Murat Ulusan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Total Laryngectomy ◽  
Self Esteem ◽  
Voice Prosthesis

Dysphagia related quality of life (QoL) following total laryngectomy (TL)

2017 ◽  
Vol 16 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Anastasios M. Georgiou ◽  
Maria Kambanaros
Keyword(s):  
Quality Of Life ◽  
Laryngeal Cancer ◽  
Total Laryngectomy ◽  
Assessment Tool ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Therapeutic Decisions ◽  
Starting Point

Abstract Purpose: This cross-sectional study evaluated the relationship between dysphagia post-total laryngectomy (TL) and quality of life (QoL) of people who reside in Greece. This is the first such report to be undertaken on the topic. Methods: Speech and language therapists typically use patient judgement to identify difficulties with swallowing. The Greek adaptations of the M.D. Anderson Dysphagia Inventory (MDADI) and the Eating Assessment Tool (EAT-10) were completed by members of the Hellenic Association of Laryngectomees (HAL). More than 400 questionnaires were sent, but only 23 were returned (18 males and 5 females). Results: The results revealed that dysphagia has a negative impact on the QoL of people who have undergone TL for treatment of laryngeal cancer. Conclusion: It appears that not only treatment (i.e. TL) of the primary disease, but also secondary problems as a result of the treatment, such as dysphagia, have a significant impact on the QoL of patients and must be taken into consideration when therapeutic decisions for laryngeal cancer are made. The qualitative measures used here provide a starting point to objectively describe QoL as perceived by TL patients. This is particularly pertinent in Greece where access to delivery and quality of health services has been challenging because of recent fiscal constraints.

Response to “Comparison of quality of life in advanced laryngeal cancer patients after concurrent chemoradiotherapy vs total laryngectomy”

2009 ◽  
Vol 140 (6) ◽  
pp. 952-952
Author(s):  
Suhail Iftekar Sayed ◽  
Kapila Manikantan ◽  
Shailesh Khode ◽  
Rehan Kazi ◽  
Rajen Shah
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Laryngeal Cancer ◽  
Total Laryngectomy ◽  
Concurrent Chemoradiotherapy

scholarly journals Voice prosthesis rehabilitation after total laryngectomy: are satisfaction and quality of life maintained over time?

2019 ◽  
Vol 39 (3) ◽  
pp. 162-168 ◽  
Author(s):  
A. Galli ◽  
L. Giordano ◽  
M. Biafora ◽  
M. Tulli ◽  
D. Di Santo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Over Time

Comparison of Quality of Life in Advanced Laryngeal Cancer Patients after Concurrent Chemoradiotherapy vs Total Laryngectomy

2008 ◽  
Vol 139 (5) ◽  
pp. 702-707 ◽  
Author(s):  
Nirav Pravin Trivedi ◽  
Dhanya Kalathungal Swaminathan ◽  
Krishnakumar Thankappan ◽  
Shilpa Chatni ◽  
Moni Abraham Kuriakose ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Laryngeal Cancer ◽  
Total Laryngectomy ◽  
Concurrent Chemoradiotherapy

Use of Larynx-Preservation Strategies in the Treatment of Laryngeal Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update

2018 ◽  
Vol 36 (11) ◽  
pp. 1143-1169 ◽  
Author(s):  
Arlene A. Forastiere ◽  
Nofisat Ismaila ◽  
Jan S. Lewin ◽  
Cherie Ann Nathan ◽  
David J. Adelstein ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Laryngeal Cancer ◽  
Total Laryngectomy ◽  
Locally Advanced ◽  
Elective Neck Dissection ◽  
Head Neck Cancer ◽  
Swallowing Function ◽  
Laryngeal Function ◽  
Larynx Preservation

Purpose To update the guideline recommendations on the use of larynx-preservation strategies in the treatment of laryngeal cancer. Methods An Expert Panel updated the systematic review of the literature for the period from January 2005 to May 2017. Results The panel confirmed that the use of a larynx-preservation approach for appropriately selected patients does not compromise survival. No larynx-preservation approach offered a survival advantage compared with total laryngectomy and adjuvant therapy as indicated. Changes were supported for the use of endoscopic surgical resection in patients with limited disease (T1, T2) and for initial total laryngectomy in patients with T4a disease or with severe pretreatment laryngeal dysfunction. New recommendations for positron emission tomography imaging for the evaluation of regional nodes after treatment and best measures for evaluating voice and swallowing function were added. Recommendations Patients with T1, T2 laryngeal cancer should be treated initially with intent to preserve the larynx by using endoscopic resection or radiation therapy, with either leading to similar outcomes. For patients with locally advanced (T3, T4) disease, organ-preservation surgery, combined chemotherapy and radiation, or radiation alone offer the potential for larynx preservation without compromising overall survival. For selected patients with extensive T3 or large T4a lesions and/or poor pretreatment laryngeal function, better survival rates and quality of life may be achieved with total laryngectomy. Patients with clinically involved regional cervical nodes (N+) who have a complete clinical and radiologic imaging response after chemoradiation do not require elective neck dissection. All patients should undergo a pretreatment baseline assessment of voice and swallowing function and receive counseling with regard to the potential impact of treatment options on voice, swallowing, and quality of life. Additional information is available at www.asco.org/head-neck-cancer-guidelines and www.asco.org/guidelineswiki .

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