Quality of Life with Voice Prosthesis after Total Laryngectomy

Abstract

Introduction: The loss of voice after total laryngectomy is one of the main impairments in personal and social life. In order to prevent potential psycho-social consequences in the patient and his family, the restoration of phonatory function is the main objective of post-laryngectomy rehabilitation. The aim of this study was to assess quality of life in patients who received prosthetic voice after total laryngectomy.

Materials and methods: Over a one-year period, 51 patients with voice prostheses after total laryngectomy were recruited. 32 patients (62.74%) were administered radiation therapy and 9 patients (17.64%) underwent to surgical reconstruction with flaps. Each patient was administered the VHI-10 and V-RQOL self-assessment questionnaires.

Results: The study showed that vocal restoration with voice prosthesis allows patients to recover a significant degree of quality of life after total laryngectomy. The average score on the V-RQOL questionnaire was 75.9 and on the VHI-10 questionnaire was 13.5. It has not been shown a statistically significant correlation between quality of life after tracheoesophageal prosthesis and radiation therapy, chemotherapy or reconstruction flaps. Younger patients showed, on average, a higher score at V-RQOL. These results allow to state that, after prosthetic rehabilitation, at least 75% of patients experienced an increase in quality of life. Moreover, the prosthetic technique (primary vs secondary) does not affect the long-term outcome and radiotherapy, chemotherapy or reconstruction flaps are not absolute contraindications to rehabilitation with voice prosthesis.

Conclusion: After total laryngectomy, rehabilitation with tracheoesophageal prosthesis is a satisfactory choice to restore the patient's ability to communicate verbally.

Keywords: Laryngectomy; Prostheses; Quality of life; Voice quality.

Fig 1

Box-Plot of the distribution of V-RQOL questionnaire scores. Q₁: 1st Quartile; Q₃: 3rd Quartile * Minimum score that does not differ from the median by more than one and a half times the interquartile range. # They differ from the median more than one and a half times the interquartile range

Fig 2

Box-Plot of the distribution of VHI-10 questionnaire scores Q₁: 1st Quartile; Q3: 3rd Quartile

Fig 3

VHI-10 score scatter plot as a fuction of the respective V-RQOL scores

Fig 4

Box-Plot of the age distribution of patients at the time of voice prosthesis placement

Fig 5

Scatter plot: scores obtained at V-RQOL as a function of the presence/absence of radiation therapy

Fig 6

Scatter plot: scores obtained at V-RQOL as a function of the presence/absence of adjuvant chemotherapy

Fig 7

Scatter plot: scores obtained at V-RQOL as a function of the presence/absence of reconstruction flaps