Alaryngeal Communication Effectiveness And Long-term Quality Of Life

ABSTRACT

Background: Primary or salvage total laryngectomy is a surgical procedure used to treat patients with advanced-stage larynxand hypopharynx cancer. The resultant alaryngeal communication is usually considered unsatisfactory and a profound impairment.Objectives: The purpose of this study was to evaluate the efficacy of alaryngeal communication after total laryngectomy andits association with long-term quality of life evaluation. Material and Methods: 82 patients with squamous cell carcinoma ofthe larynx and hypopharynx underwent a total laryngectomy associated or not with irradiation therapy. The type of alaryngealcommunication was 18 (21.9%) tracheoesophageal voice, 12 (14.6%) esophageal speech, 11 (13.4%) electrolarynx and 41(50%) non-vocal. Communication effectiveness was judged according perceptual, acoustic and temporal parameters. TheEuropean Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) was used tomeasure quality of life. Results: Tracheoesophageal voice was considered good in 13 cases (72.2%), moderate in 4 (22.2%)and poor in 1 (5.6%); esophageal speech, good in 2 (16.7%), moderate in 8 (66.6%) and poor in 2 (16.7%); electrolarynx, goodin 1 (9.1%), moderate in 9 (81.8%) and poor in 1 (9.1%); non-vocal communication, 100% poor. Total range of QLQ score variedfrom 8.3 to 100 (median, 75). Total QLQ scores were not associated with the effectiveness of communication (p=0.2512).Conclusion: Tracheoesophageal voice was more effective than esophageal speech or electrolarynx, but surprisingly alaryngealcommunication was not considered by the patients essential to maintain or improve long- term quality of life.