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Interaction of functional and participation issues on quality of life after total laryngectomy.

ABSTRACT: Objective:Total laryngectomy (TL) leads to lifelong physical changes which can lead to functional and participation issues. To assess the relationship between self-reported quality of life and functional and participation issues, a large international online questionnaire was used. Method:A questionnaire was sent out to 8119 recipients of whom 1705 (21%) responded. The questionnaire consisted of 26 questions regarding demographic information, product use of the respondents, experienced overall health and independence, and functional and participation issues. Respondents were grouped based on sex, age, time since TL, educational level, and country of residence. Questions were grouped in one measure of reported quality of life (r-QoL) and seven issue themes ("esthetic issues," "experienced limitations in daily activities," "avoiding social activities," "communication issues," "experienced vulnerability due to environmental factors," "pulmonary issues," and "sleep issues") to assess the underlying relations. Results:This study showed that more functional and participation issues and a lower r-QoL are reported in the group of younger respondents (<60?years), women, and respondents who have had the TL procedure less than 2?years ago. The issue themes "experienced limitations in daily activities" and "avoiding social activities" are related to r-QoL. Most participants report "pulmonary issues," and these issues have a strong correlation with most other themes. Conclusion:The ability to participate in meaningful and social activities is a major factor in r-QoL. Due to the frequency and strong correlations of pulmonary issues with other issue themes, pulmonary issues might be an underlying cause of many other issues. Level of evidence:3b.

SUBMITTER: Leemans M

PROVIDER: S-EPMC7314459 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Interaction of functional and participation issues on quality of life after total laryngectomy.

Leemans Maartje M van Sluis Klaske E KE van Son Rob J J H RJJH van den Brekel Michiel W M MWM

Laryngoscope investigative otolaryngology 20200415 3

<h4>Objective</h4>Total laryngectomy (TL) leads to lifelong physical changes which can lead to functional and participation issues. To assess the relationship between self-reported quality of life and functional and participation issues, a large international online questionnaire was used.<h4>Method</h4>A questionnaire was sent out to 8119 recipients of whom 1705 (21%) responded. The questionnaire consisted of 26 questions regarding demographic information, product use of the respondents, experi ...[more]

PMID: 32596487

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Project description:BACKGROUND: In this study, we aim to gather information about the quality of life issues, functional outcomes and voice problems facing early glottic cancer patients treated with the surgical techniques such as laryngofissure cordectomy, fronto-lateral laryngectomy, or cricohyoidopexi. In particular, consistency of life and voice quality issues with the laryngeal tissue excised during surgery is examined. In addition, the effects of arytenoidectomy to the life and voice quality are also studied. METHODS: 29 male patients were enrolled voluntarily in the study. The average age was 53.9 years. Three out of 10 patients with laryngofissure cordectomy also had arytenoidectomy. 11 patients had fronto-lateral laryngectomy with Tucker reconstruction, two of which also had arytenoidectomy. There were eight patients with cricohyoidopexi and bilateral functional neck dissection. Three of these patients also had arytenoidectomy. In bilateral functional neck dissection cases, spinal accessory nerve was preserved and level V of the neck was not dissected. None of the patients had neither radiotherapy nor voice therapy. Cordectomy patients never had a temporary tracheotomy or were connected to a feeding tube. Data was collected for 13 months for the cordectomy group, 14 months for fronto-lateral laryngectomy and cricohyoidopexi groups on average post-operatively. Statistical analysis in this study was carried out using the one-way analysis of variance, and the Post-Hoc group comparisons were made after Bonferroni and Scheffe-procedures.In order to determine the effects of arytenoidectomy, a regression analysis is carried out to see if there are statistical differences in answers given to the survey questions among patients who were arytenoidectomized during their surgeries. RESULTS: There was a statistically significant difference between cordectomy and cricohyoidopexi group in answers to the University of Washington- Quality of Life- Revised survey part 1. (p = 0). A statistically significant difference was also established between cordectomy and fronto-lateral laryngectomy groups, as well as between cordectomy and cricohyoidopexi groups in answers to the University of Washington- Quality of Life- Revised survey part 2. (p = 0,036 and p = 0.009, respectively). Cricohyoidopexi group has given the lowest scores and the cordectomy group has given the highest scores in three survey questions representing the quality of life, performances and new voices. These ranges are also consistent with the laryngeal tissue excised during surgery (cricohyoidopexi > fronto-lateral laryngectomy > cordectomy). There was no statistically significant difference between groups in Performance Status Scale for Head and Neck cancer patients instrument. The difference between the Voice Handicap Index and Voice Handicap Index (functional); Voice Handicap Index (physical) and Voice Handicap Index (emotional) scores in three patient groups was not significant either. All of the patients evaluated that their new voices have similar functional, physical and emotional impact on their life. Decanulation and oral feeding times of cricohyoidopexi and fronto-lateral laryngectomy patients are found to be significantly longer than cordectomy patients. Lastly, the removal of arytenoid does not have any significant adverse effects on the quality of life, the functional outcomes, or the quality of voice. CONCLUSION: In the present study, all patients with early glottic cancer, treated with different surgical technics reported fairly good quality of life outcomes, functional results and voice qualities. This study also finds that the removal of arytenoid does not have any adverse effects on the quality of life and voice from the patients' point of view.

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Interaction of functional and participation issues on quality of life after total laryngectomy.

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Interaction of functional and participation issues on quality of life after total laryngectomy.

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