Voice-Related Quality of Life in Post-Laryngectomy Rehabilitation: Tracheoesophageal Fistula’s Wellness

Salvatore Cocuzza, Antonino Maniaci, Calogero Grillo, Salvatore Ferlito, Giacomo Spinato, Salvatore Coco, Federico Merlino, Giovanna Stilo, Giovanni Paolo Santoro, Giannicola Iannella, Claudio Vicini and Ignazio La Mantia
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Salvatore Cocuzza: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy
Antonino Maniaci: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy
Calogero Grillo: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy
Salvatore Ferlito: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy
Giacomo Spinato: Section of Otorhinolaryngology, University of Padova, 31100 Treviso, Italy
Salvatore Coco: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy
Federico Merlino: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy
Giovanna Stilo: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy
Giovanni Paolo Santoro: Head and Neck and Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
Giannicola Iannella: Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, 47121 Forlì, Italy
Claudio Vicini: Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, 47121 Forlì, Italy
Ignazio La Mantia: Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy

IJERPH, 2020, vol. 17, issue 12, 1-10

Abstract: (1) Introduction: Laryngeal cancer is one of the most common types of cancer affecting the upper aerodigestive tract. Despite ensuring good oncological outcome in many locoregionally advanced cases, total laryngectomy is associated with relevant physical and psychological sequelae. Treatment through tracheo-esophageal speech, if promising, can lead to very variable outcomes. Not all laryngectomee patients with vocal prosthesis benefit from the same level of rehabilitation mainly due to the development of prosthetic or fistula related problems. The relating sequelae in some cases are even more decisive in the patient quality of life, having a higher impact than communicational or verbal skills. (2) Material and Methods: A retrospective study was conducted on 63 patients initially enrolled with a history of total laryngectomy and voice rehabilitation, treated at the University Hospital of Catania from 1 January 2010 to 31 December 2018. Quality of life (QoL) evaluation through validated self-administrated questionnaires was performed. (3) Results: The Voice-Related Quality of Life questionnaire revealed significantly better outcomes in both socio-emotional and functional domains of the tracheoesophageal patient group compared to the esophageal group ( p = 0.01; p = 0.01, respectively), whereas in the Voice Handicap Index assessment, statistically significant scores were not achieved ( p = 0.33). (4) Discussion: The significant differences reported through the V-RQOL and Voice Handicap Index scales in the presence of fistula related problems and device lifetime reduction when compared to the oesophageal speech group have demonstrated, as supported by the literature, a crucial role in the rehabilitative prognosis. (5) Conclusions: The criteria of low resistance to airflow, optimal tracheoesophageal retention, prolonged device life, simple patient maintenance, and comfortable outpatient surgery are the reference standard for obtaining good QoL results, especially over time. Furthermore, the correct phenotyping of the patient based on the main outcomes achieved at clinical follow-up guarantees the primary objective of the identification of a better quality of life.

Keywords: quality of life assessment; tracheoesophageal speech; tracheo-esophageal puncture (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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