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Integrated rehabilitation after total laryngectomy: a pilot trial study

  • Ylenia Longobardi
  • Vezio Savoia
  • Francesco Bussu
  • Luciana Morra
  • Giorgia Mari
  • Domenico A. Nesci
  • Claudio ParrillaEmail author
  • Lucia D’Alatri
Original Article
  • 27 Downloads

Abstract

Background

Acquisition and acceptance of the alaryngeal voice, psychological state, and Quality of Life (QoL) of laryngectomized patients.

Methods

Thirty-two patients who underwent total laryngectomy were included in the study; 17 of them were treated by a psychologist and a speech therapist (experimental group); 15 performed only speech therapy (control group).

Results

The experimental group showed a significant improvement in all parameters of the INFVo scale, in the score of the Environment subscale and in the total score of the I-SECEL (Self-Evaluation of Communication Experiences after Laryngeal Cancer); in the Depression, Obsession-Compulsion and Paranoia areas of the SCL-90-R (Symptom Check List-90-Revised); and in the Social area (REL) of the WHOQOL-B (World Health Organization Quality of Life Scale–Brief).

Conclusions

An integrated rehabilitative approach to laryngectomized patients improves emotional state and psychosocial aspects and promotes acceptance and use of the new voice and recovery of a better quality of life.

Keywords

Total laryngectomy Esophageal speech Tracheoesophageal speech Rehabilitation Psycho-oncology 

Notes

Compliance with ethical standards

All patients signed an informed consent. The study has been approved by the Medical Ethics Committee of the Catholic University of the Sacred Heart.

Conflict of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W, Glisson B, Trotti A, Ridge JA, Chao C, Peters G, Lee DJ, Leaf A, Ensley J, Cooper J (2003) Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 349:2091–2098CrossRefGoogle Scholar
  2. 2.
    Bussu F, Almadori G, De Corso E et al (2009) Endoscopic horizontal partial laryngectomy by CO(2) laser in the management of supraglottic squamous cell carcinoma. Head Neck 31:1196–1206CrossRefGoogle Scholar
  3. 3.
    Dinapoli N, Parrilla C, Galli J, Autorino R, Miccichè F, Bussu F, Balducci M, D’Alatri L, Marchese R, Rigante M, di Lella G, Liberati L, Almadori G, Paludetti G, Valentini V (2010) Multidisciplinary approach in the treatment of T1 glottic cancer. The role of patient preference in a homogenous patient population. Strahlenther Onkol 186:607–613CrossRefGoogle Scholar
  4. 4.
    Bussu F, Micciche F, Rigante M et al (2012) Oncologic outcomes in advanced laryngeal squamous cell carcinomas treated with different modalities in a single institution: a retrospective analysis of 65 cases. Head Neck 34:573–579CrossRefGoogle Scholar
  5. 5.
    Bussu F, Paludetti G, Almadori G, de Virgilio A, Galli J, Miccichè F, Tombolini M, Rizzo D, Gallo A, Giglia V, Greco A, Valentini V, de Vincentiis M (2013) Comparison of total laryngectomy with surgical (cricohyoidopexy) and nonsurgical organ-preservation modalities in advanced laryngeal squamous cell carcinomas: a multicenter retrospective analysis. Head Neck 35:554–561CrossRefGoogle Scholar
  6. 6.
    Jenckel F, Knecht R (2013) State of the art in the treatment of laryngeal cancer. Anticancer Res 33:4701–4710PubMedGoogle Scholar
  7. 7.
    Bindewald J, Herrmann E, Dietz A, Wulke C, Meister E, Wollbrück D, Singer S (2007) Quality of life and voice intelligibility in laryngeal cancer patients--relevance of the “satisfaction paradox”. Laryngorhinootologie 86:426–430CrossRefGoogle Scholar
  8. 8.
    Chawla S, Carney AS (2009) Organ preservation surgery for laryngeal cancer. Head Neck Oncol 1:12CrossRefGoogle Scholar
  9. 9.
    Hoffman HT, Porter K, Karnell LH, Cooper JS, Weber RS, Langer CJ, Ang KK, Gay G, Stewart A, Robinson RA (2006) Laryngeal cancer in the United States: changes in demographics, patterns of care, and survival. Laryngoscope 116:1–13CrossRefGoogle Scholar
  10. 10.
    Richard JM, Sancho-Garnier H, Pessey JJ, Luboinski B, Lefebvre JL, Dehesdin D, Stromboni-Luboinski M, Hill C (1998) Randomized trial of induction chemotherapy in larynx carcinoma. Oral Oncol 34:224–228CrossRefGoogle Scholar
  11. 11.
    Danker H, Wollbrück D, Singer S et al (2010) Social withdrawal after laryngectomy. Head Neck 267:593–600Google Scholar
  12. 12.
    Singer S, Krauss O, Keszte J et al (2011) Predictors of emotional distress in patients with head and neck cancer. Head Neck 34:180–187CrossRefGoogle Scholar
  13. 13.
    Almonacid CI, Ramos AJ, Rodriguez-Borego MA (2016) Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients. Rev Lat Am Enfermagem 24:e2707CrossRefGoogle Scholar
  14. 14.
    Yılmaz M, Yener M, Yollu U, Akil F, Haciyev Y, Yargic I, Karaman E, Cansiz H (2015) Depression, self-esteem and sexual function in laryngeal cancer patients. Clin Otolaryngol 40:349–354CrossRefGoogle Scholar
  15. 15.
    Misono S, Weiss NS, Fann JR et al (2008) Incidence of suicide in persons with cancer. J Clin Oncol 29:4731–4738CrossRefGoogle Scholar
  16. 16.
    Serra A, Di Mauro P, Spataro D et al (2015) Post-laryngectomy voice rehabilitation with voice prosthesis: 15 years experience of the ENT Clinic of University of Catania. Retrospective data analysis and literature review. Acta Otorhinolaryngol Ital 35:412–419PubMedPubMedCentralGoogle Scholar
  17. 17.
    Macri GF, Bogaartd H, Parrilla C et al (2013) Patients’ experiences with HMEs and attachments after total laryngectomy. Head Neck 35:1583–1590CrossRefGoogle Scholar
  18. 18.
    Singer S, Wollbruck D, Dietz A et al (2013) Speech rehabilitation during the first year after total laryngectomy. Head Neck 35:1583–1590CrossRefGoogle Scholar
  19. 19.
    Parrilla C, Minni A, Bogaartd H et al (2015) Pulmonary rehabilitation after total laryngectomy: a multicenter time-series clinical trial evaluating the Provox XtraHME in HME-Naive patients. Ann Otol Rhinol Laryngol 124:706–713CrossRefGoogle Scholar
  20. 20.
    Doyle PC, Keith RL (2005) Contemporary considerations in the treatment and rehabilitation of head and neck cancer: voice, speech and swallowing. Pro-ed., Austin, pp 76–77Google Scholar
  21. 21.
    Eadie TL, Otero D, Cox S et al (2016) The relationship between communicative participation and postlaryngectomy speech outcomes. Head Neck 38:955–961CrossRefGoogle Scholar
  22. 22.
    Danker H, Wollbruk D, Singer S et al (2010) Social withdrawal after laryngectomy. Eur Arch Otorhinolaryngol 267:593–600CrossRefGoogle Scholar
  23. 23.
    Turrini M, Cutugno F, Maturi P et al (1993) Bisyllabic words for speech audiometry: a new Italian material. Acta Otorhinolaryngol Ital 13:63–77PubMedGoogle Scholar
  24. 24.
    Moerman M, Martens JP, Crevier-Buchman L, Haan E, Grand S, Tessier C, Woisard V, Dejonckere P (2006) The INFVo perceptual rating scale for substitution voicing: development and reliability. Eur Arch Otorhinolaryngol 263:435–439CrossRefGoogle Scholar
  25. 25.
    Schindler A, Ginocchio D, Atac M et al (2013) Reliability of the Italian INFVo scale and correlations with objective measures and VHI scores. Acta Otorhinolaryngol Ital 33:121–127PubMedPubMedCentralGoogle Scholar
  26. 26.
    Schindler A, Mozzanica F, Brignoli F, Maruzzi P, Evitts P, Ottaviani F (2013) Reliability and validity of the Italian self-evaluation of communication experiences after laryngeal cancer questionnaire. Head Neck 35:1606–1615CrossRefGoogle Scholar
  27. 27.
    Blood GW (1993) Development and assessment of a scale addressing communication needs of patients with laryngectomies. Am J Speech Lang Pathol 2:82–90CrossRefGoogle Scholar
  28. 28.
    Derogatis LR (1994) Symptom check list-90-R: administration, scoring and procedures manual, Third edn. National computer systems, MinneapolisGoogle Scholar
  29. 29.
    Sarno L, Preti E, Prunas A et al (2011) SCL-90-R Symptom Checklist-90-R Adattamento Italiano. Giunti Organizzazioni Speciali, FirenzeGoogle Scholar
  30. 30.
    WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 28:551–558CrossRefGoogle Scholar
  31. 31.
    The WHOQOL Group (1994) The development of the World Health Organization Quality Of Life assessment instrument (the WHOQOL). In: Orley J, Kuyken W (eds) Quality of life assessment: international perspective. Springer Verlag, Heidelberg, pp 41–57CrossRefGoogle Scholar
  32. 32.
    DeGirolamo G, Rucci P, Scocco A et al (2000) La valutazione della Qualità della Vita: validazione del WHOQOL-breve. Epidemiol Psichiatr Soc 9:45–55CrossRefGoogle Scholar
  33. 33.
    Hirani I, Siddiqui AH, Muhammad Khyani IA (2015) Apprehensions and problems after laryngectomy: patients’ perspective. J Pak Med Assoc 65:1214–1218PubMedGoogle Scholar
  34. 34.
    Keszte J, Danker H, Dietz A, Meister E, Pabst F, Vogel HJ, Meyer A, Singer S (2013) Mental disorders and psychosocial support during the first year after total laryngectomy: a prospective cohort study. Clin Otolaryngol 38:494–501CrossRefGoogle Scholar
  35. 35.
    Maclean J, Cotton S, Perry A (2009) Dysphagia following a total laryngectomy: the effect on quality of life, functioning, and psychological well-being. Dysphagia 24:314–321CrossRefGoogle Scholar
  36. 36.
    Laver J (1980) The phonetic description of voice quality. Cambridge University Press, CambridgeGoogle Scholar
  37. 37.
    Bickford J, Coveney J, Baker J, Hersh D (2013) Living with the altered self: a qualitative study of life after total laryngectomy. Int J Speech Lang Pathol 15:324–333CrossRefGoogle Scholar
  38. 38.
    D’Alatri L, Bussu F, Scarano E, Paludetti G, Marchese MR (2012) Objective and subjective assessment of tracheoesophageal prosthesis voice outcome. J Voice 26:607–613CrossRefGoogle Scholar
  39. 39.
    Eadie TL, Day AM, Sawin DE et al (2013) Auditory-perceptual speech outcomes and quality of life after total laryngectomy. Otolaryngol Head Neck Surg 148:82–88CrossRefGoogle Scholar
  40. 40.
    Perry A, Casey E, Cotton S (2015) Quality of life after total laryngectomy: functioning psychological well-being and self-efficacy. Int J Lang Commun Disord 50:467–475CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Fondazione Policlinico Universitario A. Gemelli IRCCS – Università Cattolica del Sacro Cuore, Istituto di OtorinolaringoiatriaRomeItaly
  2. 2.Fondazione Policlinico Universitario A. Gemelli IRCCS, Unità di Consultazione PsichiatricaRomeItaly
  3. 3.Otolaryngology DivisionAOU SassariSassariItaly
  4. 4.Università Cattolica del Sacro Cuore, Istituto di OtorinolaringoiatriaRomeItaly

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