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Communication changes with laryngectomy and impact on quality of life: a review

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Abstract

Purpose

Patients with throat cancer at later stages often undergo total laryngectomy, a procedure that removes the larynx (voice box) and directly impacts the patient’s ability to produce natural voice and communication. This narrative review aimed to explore how changes to communication following laryngectomy may impact quality of life (QoL) for patients.

Methods

Literature searches were conducted using CINAHL, MEDLINE and PsychInfo databases for studies published between 2007 and 2018. The search terms (and derivatives) of laryngectomy AND communication AND quality of life were used. A synthesis and appraisal of the studies was conducted.

Results

Twelve studies met the inclusion criteria and were included in this review. The two main themes identified relating to changes in communication and impact on QoL were changes in communication competency (immediate changes and communication option used) and adaptation to change (e.g. self-related factors and relationships with others). Regardless of the type of communication option used, participants in all studies reported negative changes in their communication competency and QoL post-laryngectomy. Voice-related factors and aesthetics of the communication option used were noted to influence self-ratings of QoL for the participants, rather than how well others understood them. Participants using tracheoesophageal speech (TES) consistently showed the highest self-reported QoL across the majority of studies. A model incorporating the findings from this review has been proposed which outlines how changes in communication post-laryngectomy may lead to an impact on QoL. Here, the factors of changes in communication competency, self-perception and social engagement impact each other and are also influenced by adaptation to change.

Conclusion

This review has highlighted the complex nature of changes faced by patients following laryngectomy in relation to communication and QoL. The model linking communication changes to QoL may become a useful tool for researchers and clinicians in supporting the management of patients post-laryngectomy.

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Authors and Affiliations

  1. School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia

    Gabriella Sharpe & Paul Carding

  2. Faculty of Arts, Health and Design, Swinburne University of Technology, Melbourne, Australia

    Vera Camoes Costa

  3. School of Arts, Social Sciences and Humanities, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia

    Wendy Doubé

  4. School of Science, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia

    Jodi Sita

  5. School of Software and Electrical Engineering, Faculty of Science, Engineering and Technology, Swinburne University of Technology, Melbourne, Australia

    Chris McCarthy

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  1. Gabriella Sharpe
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Correspondence to Gabriella Sharpe.

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Sharpe, G., Camoes Costa, V., Doubé, W. et al. Communication changes with laryngectomy and impact on quality of life: a review. Qual Life Res 28, 863–877 (2019). https://doi.org/10.1007/s11136-018-2033-y

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