OBJECTIVE: To determine the effects of a total laryngectomy on the swallow and subsequent quality of life in head and neck cancer patients. DESIGN: Cross-sectional single centre cohort study. SETTING: Head and Neck Oncology Unit, Tertiary Referral Unit. PATIENTS: Sixty-two patients who underwent total laryngectomy at our centre participated in the study. METHODS: Subjects were stratified by age, sex, tumour stage, other procedures such as myotomy and nerve re-implantation. Pharyngectomy, glossectomy, flap reconstruction, neck dissection and previous radio- and chemotherapy were also assessed to see if they affected swallow and subsequent quality of life. Main outcome was measured using the MD Anderson Dysphagia Inventory questionnaire. RESULTS: Responses were received from 46 males and 16 females (response rate of 80.5%) with a mean age of 64.7 years (SD 9.4). Median follow-up in patients was 90 months (range 1-276). The mean MD Anderson Dysphagia Inventory total score in our series of patients was 77.7 (SD 16.6). MD Anderson Dysphagia Inventory global score was 79.4 (SD 22.6), Emotional score was 77.7 (SD 17.8), Functional score 81.3 (SD 15.9) and Physical score was 74.1(SD 18). Statistically significant differences were seen between the emotional scores of glossectomised and non-glossectomised patients (Mann Whitney, P = 0.04). No significant correlation was seen between the subscale scores and the remaining treatment variables such as age, gender, site, tumour stage, myotomy, nerve implantation, radiotherapy, reconstruction and major complications. CONCLUSION: This questionnaire study is the largest of its type to assess the swallow of patients who have undergone laryngectomy at a single centre. The overall result confirmed that most patients had a subjectively good swallow. Only glossectomy and the method of PE segment closure were shown to significantly affect swallowing outcomes following surgery. We recommend further work especially prospective studies pre and post surgery using this or similarly validated instruments to fully assess swallow in the laryngectomy population.
OBJECTIVE: To determine the effects of a total laryngectomy on the swallow and subsequent quality of life in head and neck cancerpatients. DESIGN: Cross-sectional single centre cohort study. SETTING: Head and Neck Oncology Unit, Tertiary Referral Unit. PATIENTS: Sixty-two patients who underwent total laryngectomy at our centre participated in the study. METHODS: Subjects were stratified by age, sex, tumour stage, other procedures such as myotomy and nerve re-implantation. Pharyngectomy, glossectomy, flap reconstruction, neck dissection and previous radio- and chemotherapy were also assessed to see if they affected swallow and subsequent quality of life. Main outcome was measured using the MD Anderson Dysphagia Inventory questionnaire. RESULTS: Responses were received from 46 males and 16 females (response rate of 80.5%) with a mean age of 64.7 years (SD 9.4). Median follow-up in patients was 90 months (range 1-276). The mean MD Anderson Dysphagia Inventory total score in our series of patients was 77.7 (SD 16.6). MD Anderson Dysphagia Inventory global score was 79.4 (SD 22.6), Emotional score was 77.7 (SD 17.8), Functional score 81.3 (SD 15.9) and Physical score was 74.1(SD 18). Statistically significant differences were seen between the emotional scores of glossectomised and non-glossectomised patients (Mann Whitney, P = 0.04). No significant correlation was seen between the subscale scores and the remaining treatment variables such as age, gender, site, tumour stage, myotomy, nerve implantation, radiotherapy, reconstruction and major complications. CONCLUSION: This questionnaire study is the largest of its type to assess the swallow of patients who have undergone laryngectomy at a single centre. The overall result confirmed that most patients had a subjectively good swallow. Only glossectomy and the method of PE segment closure were shown to significantly affect swallowing outcomes following surgery. We recommend further work especially prospective studies pre and post surgery using this or similarly validated instruments to fully assess swallow in the laryngectomy population.
Authors: Weidong Lu; Peter M Wayne; Roger B Davis; Julie E Buring; Hailun Li; Laura A Goguen; David S Rosenthal; Roy B Tishler; Marshall R Posner; Robert I Haddad Journal: Contemp Clin Trials Date: 2012-03-02 Impact factor: 2.226
Authors: Z Saltürk; A Arslanoğlu; E Özdemir; G Yıldırım; İ Aydoğdu; T L Kumral; G Berkiten; Y Atar; Y Uyar Journal: HNO Date: 2016-03 Impact factor: 1.284
Authors: K A Lightbody; M D Wilkie; A J Kinshuck; E Gilmartin; H Lewis-Jones; T M Jones; J Lancaster Journal: Ann R Coll Surg Engl Date: 2015-10 Impact factor: 1.891
Authors: Leandro de Araújo Pernambuco; Jabson Herber Profiro de Oliveira; Renata Milena Freitas Lima Régis; Leilane Maria de Lima; Ana Maria Bezerra de Araújo; Patrícia Maria Mendes Balata; Daniele Andrade da Cunha; Hilton Justino da Silva Journal: Int Arch Otorhinolaryngol Date: 2012-10
Authors: Abdelrahim Y Attieh; Jeff Searl; Nada H Shahaltough; Mahmoud M Wreikat; Donna S Lundy Journal: Health Qual Life Outcomes Date: 2008-03-28 Impact factor: 3.186