Voice outcomes post total laryngectomy

Abstract

Purpose of review: A consensus and body of robust evidence has developed regarding optimal laryngeal voice outcome measures. This contrasts with a lack of clarity for equivalent assessments in alaryngeal voice. Addressing this situation would enable clinicians to select the best tools currently available to facilitate research, audit and clinical practice. This is important because of the limited knowledge regarding the optimal surgical or reconstruction techniques and rehabilitation regimes for the laryngectomy population.

Recent findings: There is currently no evidence to support the use of acoustic instrumental measures in terms of validity. Preliminary data support the validity of a new tracheoesophageal voice auditory-perceptual tool the SToPS, for professional and naive raters. Few specific self-rating tools exist with the Self Evaluation of Communication Experiences after Laryngectomy having the most evidence regarding validity, reliability and clinical utility. Laryngeal self-report questionnaires have been utilized, but concerns have been expressed regarding content validity. Patient self-report outcomes do not concur with professional or naive judgements, which reflect findings in the laryngeal voice literature.

Summary: Further research is needed to establish the optimal tools for research and clinical practice. Investigations should also incorporate assessments of real-life communication in daily living rather than solely focussing on recordings in laboratory conditions.