Management of total laryngectomy patients over time: from the consultation announcing the diagnosis to long term follow-up



Throat cancer has always struck people’s imagination. This type of cancer affects some of the patient’s most essential physiological functions: speaking, swallowing and breathing. At advanced stages, radical surgery is disabling. The impact of a mutilated larynx corresponds to a very real trauma that is both individual and social. Our aim is to define how a total laryngectomy (TL) is represented by both the surgeon and the patient. The history of TL makes it possible to understand the changes that were needed for the key players in the subject to impose or accept this operation. Without doubt, the implementation of the “cancer plan” in the early 2000s was a major turning point in the management of patients with neoplasia. Increased awareness among the elite, encouraged by the mobilisation of patients and their families, is the explanation for the new role played by TL in 2008. The progress made in medical and surgical techniques, modifications to the patient–carer relationship and the appearance of the concept of Quality of Life are all themes that have changed the approach to this operation and the management of patients undergoing a TL.


Laryngeal neoplasms Total laryngectomy Quality of life Consultation announcing Screening History of medicine 


  1. 1.
    Armstrong E, Isman K, Dooley P, Brine D, Riley N, Dentice R, King S, Khanbhai F (2001) An investigation into the quality of life of individuals after laryngectomy. Head Neck 23:16–24CrossRefGoogle Scholar
  2. 2.
    Babin E (2001) Life after total laryngectomy. Rev Laryngol Otol Rhinol (Bord) 122:303–309Google Scholar
  3. 3.
    Babin E, Joly F, Vadillo M, Dehesdin D (2005) Oncology and quality of life. Study in head and neck cancer. Ann Otolaryngol Chir Cervicofac 122:134–141PubMedCrossRefGoogle Scholar
  4. 4.
    Becker HS (1985) Outsiders: études de sociologie de la déviance. A.-M. Métailié, ParisGoogle Scholar
  5. 5.
    Bjordal K, Kaasa S (1995) Psychological distress in head and neck cancer patients 7–11 years after curative treatment. Br J Cancer 71:592–597PubMedCrossRefGoogle Scholar
  6. 6.
    Carr MM, Schmidbauer JA, Majaess L, Smith RL (2000) Communication after laryngectomy: an assessment of quality of life. Otolaryngol Head Neck Surg 122:39–43PubMedCrossRefGoogle Scholar
  7. 7.
    Castel R (1991) De l’indigence à l’exclusion, la désaffiliation. Précarité du travail et vulnérabilité relationnelle. Esprit, ParisGoogle Scholar
  8. 8.
    David DJ, Barritt JA (1982) Psychosocial implications of surgery for head and neck cancer. Clin Plast Surg 9:327–336PubMedGoogle Scholar
  9. 9.
    De Raucourt D, Blanchet F, Rame JP, Luquet A, Rossa Y (1989) Prosthetic vocal rehabilitation of Herrmann’s type after total laryngectomy. Results apropos of 29 cases. Ann Otolaryngol Chir Cervicofac 106:583–588PubMedGoogle Scholar
  10. 10.
    Deleyiannis FW, Weymuller EA Jr, Coltrera MD, Futran N (1999) Quality of life after laryngectomy: are functional disabilities important? Head Neck 21:319–324PubMedCrossRefGoogle Scholar
  11. 11.
    DeSanto LW, Olsen KD, Perry WC, Rohe DE, Keith RL (1995) Quality of life after surgical treatment of cancer of the larynx. Ann Otol Rhinol Laryngol 104:763–769PubMedGoogle Scholar
  12. 12.
    Freidson E (1984) La profession médicale (1970). Payot, ParisGoogle Scholar
  13. 13.
    Gates GA, Hearne EM 3rd (1982) Predicting esophageal speech. Ann Otol Rhinol Laryngol 91:454–457PubMedGoogle Scholar
  14. 14.
    Goffman E (1975) Stigmate: les usages sociaux des handicaps. Editions de Minuit, ParisGoogle Scholar
  15. 15.
    TDoVALCS Group (1991) Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324:1685–1690CrossRefGoogle Scholar
  16. 16.
    Guerrier Y, Mounier-Kuhn P, Mounier-Kuhn P (1980) Histoire des maladies de l’oreille, du nez et de la gorge: les grandes étapes de l’oto-rhino-laryngologie. Dacosta, ParisGoogle Scholar
  17. 17.
    Herranz J, Gavilan J (1999) Psychosocial adjustment after laryngeal cancer surgery. Ann Otol Rhinol Laryngol 108:990–997PubMedGoogle Scholar
  18. 18.
    Illich I (2003) Medical nemesis. J Epidemiol Community Health 57:919–922PubMedCrossRefGoogle Scholar
  19. 19.
    Janot F, Rhein B, Koka VN, Wibault P, Domenge C, Bessede JP, Marandas P, Schwaab G, Luboinski B (2002) Laryngeal preservation with induction chemotherapy. Experience of two GETTEC centers, between 1985 and 1995,p 12Google Scholar
  20. 20.
    Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ (2009) Cancer statistics, 2009. CA Cancer J Clin 59:225–249PubMedCrossRefGoogle Scholar
  21. 21.
    Laccourreye H (2000) Evolution of surgical treatment for cancer of the larynx in the 20th century. Ann Otolaryngol Chir Cervicofac 117:237–247PubMedGoogle Scholar
  22. 22.
    Lee-Preston V, Steen IN, Dear A, Kelly CG, Welch AR, Meikle D, Stafford FW, Wilson JA (2004) Optimizing the assessment of quality of life after laryngeal cancer treatment. J Laryngol Otol 118:432–438PubMedCrossRefGoogle Scholar
  23. 23.
    Lévi-Strauss C (1971) Anthropologie structurale deux: avec 13 schémas dans le texte. Plon, ParisGoogle Scholar
  24. 24.
    List MA, Ritter-Sterr CA, Baker TM, Colangelo LA, Matz G, Pauloski BR, Logemann JA (1996) Longitudinal assessment of quality of life in laryngeal cancer patients. Head Neck 18:1–10PubMedCrossRefGoogle Scholar
  25. 25.
    Marandas P, Marandas N (2000) Surveillance of patients treated for a cervico-facial cancer. Bull Cancer Suppl 5:49–53Google Scholar
  26. 26.
    Mathieson CM, Stam HJ, Scott JP (1990) Psychosocial adjustment after laryngectomy: a review of the literature. J Otolaryngol 19:331–336PubMedGoogle Scholar
  27. 27.
    Ménoret M, Pharo P (1999) Les temps du cancer. CNRS éditions, ParisGoogle Scholar
  28. 28.
    Mohide EA, Archibald SD, Tew M, Young JE, Haines T (1992) Postlaryngectomy quality-of-life dimensions identified by patients and health care professionals. Am J Surg 164:619–622PubMedCrossRefGoogle Scholar
  29. 29.
    Morton RP (1997) Laryngeal cancer: quality-of-life and cost-effectiveness. Head Neck 19:243–250PubMedCrossRefGoogle Scholar
  30. 30.
    Muller R, Paneff J, Kollner V, Koch R (2001) Quality of life of patients with laryngeal carcinoma: a post-treatment study. Eur Arch Otorhinolaryngol 258:276–280PubMedCrossRefGoogle Scholar
  31. 31.
    Murphy R (1990) Vivre à corps perdu. Terre humaine, PlonGoogle Scholar
  32. 32.
    Nahum AM, Golden JS (1963) Psychological Problems of Laryngectomy. Jama 186:1136–1138PubMedGoogle Scholar
  33. 33.
    Natvig K (1984) Laryngectomees in Norway. Study no. 5: problems of everyday life. J Otolaryngol 13:15–22PubMedGoogle Scholar
  34. 34.
    Natvig K (1983) Study No. 1: social, personal, and behavioral factors related to present mastery of the laryngectomy event. J Otolaryngol 12:155–162PubMedGoogle Scholar
  35. 35.
    Nijdam HF, Annyas AA, Schutte HK, Leever H (1982) A new prosthesis for voice rehabilitation after laryngectomy. Eur Arch Otorhinolaryngol 237:27–33CrossRefGoogle Scholar
  36. 36.
    Paul A (2002) Le regard de l’ethnographe. Petite épistémologie de la recherche sur le terrain, Mana Revue de sociologie et d’anthropologie 10–11. Presse Universitaire deCaen, CaenGoogle Scholar
  37. 37.
    Perros G (1978) Papiers collés III. Gallimard, ParisGoogle Scholar
  38. 38.
    Pruyn JF, de Jong PC, Bosman LJ, van Poppel JW, van Den Borne HW, Ryckman RM, de Meij K (1986) Psychosocial aspects of head and neck cancer—a review of the literature. Clin Otolaryngol Allied Sci 11:469–474PubMedCrossRefGoogle Scholar
  39. 39.
    Relic A, Mazemda P, Arens C, Koller M, Glanz H (2001) Investigating quality of life and coping resources after laryngectomy. Eur Arch Otorhinolaryngol 258:514–517PubMedCrossRefGoogle Scholar
  40. 40.
    Stam HJ, Koopmans JP, Mathieson CM (1991) The Psychosocial Impact of a Laryngectomy. J Psychosoc Oncol 9:37–58CrossRefGoogle Scholar
  41. 41.
    Strauss AL, Baszanger I (1992) La trame de la négociation: sociologie qualitative et interactionnisme. L’Harmattan, ParisGoogle Scholar
  42. 42.
    Taylor JC, Terrell JE, Ronis DL, Fowler KE, Bishop C, Lambert MT, Myers LL, Duffy SA, Bradford CR, Chepeha DB, Hogikyan ND, Prince ME, Teknos TN, Wolf GT (2004) Disability in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 130:764–769PubMedCrossRefGoogle Scholar
  43. 43.
    Terrell JE, Fisher SG, Wolf GT (1998) Long-term quality of life after treatment of laryngeal cancer. Arch Otolaryngol Head Neck Surg 124:964PubMedGoogle Scholar
  44. 44.
    Terrell JE, Ronis DL, Fowler KE, Bradford CR, Chepeha DB, Prince ME, Teknos TN, Wolf GT, Duffy SA (2004) Clinical predictors of quality of life in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 130:401–408PubMedCrossRefGoogle Scholar
  45. 45.
    Traissac L, Devars F, Gioux M, Petit J, Benjebria A, Henry C, Ucelay I (1987) Vocal rehabilitation of the total laryngectomized patient by phonatory implant, current results. Rev Laryngol Otol Rhinol (Bord) 108:157–159Google Scholar
  46. 46.
    Vilaseca I, Chen AY, Backscheider AG (2006) Long-term quality of life after total laryngectomy. Head Neck 28:313–320PubMedCrossRefGoogle Scholar
  47. 47.
    Wethington E, Kessler RC (1986) Perceived support, received support, and adjustment to stressful life events. J Health Soc Behav 27:78–89PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Emmanuel Babin
    • 1
    • 2
  • David Blanchard
    • 1
  • Martin Hitier
    • 1
  1. 1.Otolaryngology-Head and Neck SurgeryUniversity HospitalCaenFrance
  2. 2.Laboratoire ERI3 Inserm “Cancers et Population”, and CERReV-Centre d’Etude et de Recherche sur les Risques Et les VulnérabilitésUniversity of CaenCaenFrance

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