Klaske E van Sluis1,2, Rob J J H van Son3,4, Lisette van der Molen3,4, Anthony John MCGuinness5,6, Carsten E Palme5,7,8,9, Daniel Novakovic5,9, Danielle Stone8, Lydia Natsis7, Emma Charters5, Kelly Jones6, Richard Dirven3, Michiel W M van den Brekel3,4. 1. Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands. k.v.sluis@nki.nl. 2. Amsterdam Center for Language and Communication, University of Amsterdam, Amsterdam, The Netherlands. k.v.sluis@nki.nl. 3. Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands. 4. Amsterdam Center for Language and Communication, University of Amsterdam, Amsterdam, The Netherlands. 5. Head and Neck Department, Department of Surgery, Chris O'Brien Lifehouse Hospital, Sydney, NSW, Australia. 6. Department of Ear, Nose and Throat, Head and Neck Surgery, Liverpool Hospital, Liverpool, NSW, Australia. 7. Department of Head and Neck Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia. 8. Department of Surgery, Ear Nose & Throat, Westmead Hospital, Westmead, NSW, Australia. 9. Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Abstract
PURPOSE: The purpose of this study is to assess the general course of acoustic, patient rated, and clinician-rated voice outcomes from pre- up to 12 months post total laryngectomy. METHODS: Patients admitted to a total laryngectomy in five participating hospitals in Australia and The Netherlands were included. Assessments took place at pre-, 3 months, 6 months, and 12 months post-surgery. Voice outcomes are evaluated with the Acoustic Voice Quality Index (AVQI), perceptual scales, and patient-reported outcome measures including VHI-10 and EQ-5D-5L. Statistical analyses include descriptive statistics, t tests (pre- to 6 months post-surgery), Linear Mixed Effect models. RESULTS: The study included 43 participants. A significant worsening of AVQI is seen from pre- to post-surgery evaluated with t test (p < 0.001). The Linear Mixed Effect model confirmed Time as a significant factor in predicting AVQI score (p ≤ 0.001), as well as perceptual rated voice quality by the clinician (p = 0.015) and patient-reported perceptual rated voice quality (p = 0.002). No statistical significance was found in VHI-10 scores over time. CONCLUSION: Successful TE-speech was achieved in most participants, some had to rely on augmentative alternative communication methods. Patient-reported outcomes indicate acceptance of the condition and sufficient coping in the long term. However, acoustic rated voice quality is abnormal at all post-surgery time-points. AVQI proved to be a useful instrument to evaluate TE-speech. There is a need for validation and determination of cut-off values for VHI-10 and AVQI for use in TE-speech.
PURPOSE: The purpose of this study is to assess the general course of acoustic, patient rated, and clinician-rated voice outcomes from pre- up to 12 months post total laryngectomy. METHODS:Patients admitted to a total laryngectomy in five participating hospitals in Australia and The Netherlands were included. Assessments took place at pre-, 3 months, 6 months, and 12 months post-surgery. Voice outcomes are evaluated with the Acoustic Voice Quality Index (AVQI), perceptual scales, and patient-reported outcome measures including VHI-10 and EQ-5D-5L. Statistical analyses include descriptive statistics, t tests (pre- to 6 months post-surgery), Linear Mixed Effect models. RESULTS: The study included 43 participants. A significant worsening of AVQI is seen from pre- to post-surgery evaluated with t test (p < 0.001). The Linear Mixed Effect model confirmed Time as a significant factor in predicting AVQI score (p ≤ 0.001), as well as perceptual rated voice quality by the clinician (p = 0.015) and patient-reported perceptual rated voice quality (p = 0.002). No statistical significance was found in VHI-10 scores over time. CONCLUSION: Successful TE-speech was achieved in most participants, some had to rely on augmentative alternative communication methods. Patient-reported outcomes indicate acceptance of the condition and sufficient coping in the long term. However, acoustic rated voice quality is abnormal at all post-surgery time-points. AVQI proved to be a useful instrument to evaluate TE-speech. There is a need for validation and determination of cut-off values for VHI-10 and AVQI for use in TE-speech.
Entities:
Keywords:
Acoustics; Patient-reported; Perceptual; Total laryngectomy; Voice outcome