ABSTRACT
The study included 62 patients with morphologically verified squamous cell carcinoma of laryngopharynx, stages T2-4N0-2M0. As a result of the treatment complete regression was recorded in 28.1 ± 7.9% of cases, partial regression--in 50.0 ± 8.8% of patients, and stabilization--in 21.9 ± 7.3% of cases. The total efficiency of therapy made up 78.1 ± 7.3%. Chemotherapy complications and radiation injuries did not exceed I-II grade by CTC-NCIC criteria and PTOG/EORTC scale, were easily stopped, did not affect the time periods of further treatment and had no considerable influence on the postoperative period. Conservative surgery was performed in 26% of cases. The total 5-year survival rate made up 65.4 ± 8.4%, relapse-free 5-year survival rate--60.6 ± 8.9%. The efficiency of the vocal function rehabilitation made up 73.9 ± 9.1%. Rehabilitation time was 21 ± 8.2 days.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/therapy , Head and Neck Neoplasms/therapy , Laryngeal Neoplasms/therapy , Laryngectomy , Neoadjuvant Therapy/methods , Pharyngeal Neoplasms/therapy , Pharyngectomy , Adult , Aged , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/rehabilitation , Chemoradiotherapy, Adjuvant/adverse effects , Disease-Free Survival , Female , Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/rehabilitation , Humans , Kaplan-Meier Estimate , Laryngeal Neoplasms/mortality , Laryngeal Neoplasms/pathology , Laryngectomy/methods , Male , Middle Aged , Neoplasm Staging , Pharyngeal Neoplasms/mortality , Pharyngeal Neoplasms/pathology , Pharyngectomy/methods , Remission Induction , Speech , Squamous Cell Carcinoma of Head and Neck , Treatment Outcome , Vocal Cord Dysfunction/etiology , Vocal Cord Dysfunction/rehabilitation , Vocal Cords/drug effects , Vocal Cords/radiation effects , Vocal Cords/surgeryABSTRACT
The objective of the present study was to enhance the effectiveness of vocal rehabilitation and to improve the quality of life in the patients presenting with laryngeal cancer after organ-preserving surgical interventions. The study included 98 patients presenting with stage II-III laryngeal cancer who underwent organ-preserving surgery and postoperative vocal rehabilitation. The comprehensive approach to the restoration of the vocal function has been developed and clinically applied that includes rational psychotherapy, respiratory gymnastics for the correction of physiological and phonation breathing, activation of the neuromuscular apparatus of the external and the residual internal larynx and neck muscles , coordination of the vocal apparatus at the expense of compensation of the remaining part of the larynx taking advantage of the biological feedback mechanism based on the results of mathematical simulation. The application of this approach in clinical settings made it possible to increase the effectiveness of vocal rehabilitation up to 93%, reduce the number of disabled subjects, restore the working abilities in the patients of the employable age, significantly promote their social adaptation, and improve the life quality.
Subject(s)
Laryngeal Neoplasms/surgery , Larynx/physiopathology , Postoperative Complications/rehabilitation , Voice Quality/physiology , Adult , Aged , Exercise Therapy/methods , Humans , Laryngeal Neoplasms/complications , Larynx/surgery , Middle Aged , Neoplasm Staging , Postoperative Period , Psychotherapy/methods , Quality of Life/psychology , Social Adjustment , Treatment OutcomeABSTRACT
The study included patients with laryngeal cancer (stage III-IV) after laryngectomy. They underwent vocal rehabilitation assisted by biological monitoring using mathematical modeling and computer technology. EORTS QLQ-C30 questionnaires 30 (version 3.0) were used to assess quality of life as a tool of rehabilitative effect evaluation (special QLQ-N&N35 for head and neck tumor patients). Physical, psychological, social and symptomatic parameters were followed through the stages of vocal rehabilitation. On completion of therapy, patients spoke freely; 68% of them recovered their social and professional status.
Subject(s)
Laryngeal Neoplasms/rehabilitation , Laryngectomy/adverse effects , Phonation , Quality of Life , Speech, Alaryngeal , Voice , Adult , Aged , Computer Simulation , Employment , Female , Humans , Laryngeal Neoplasms/pathology , Laryngeal Neoplasms/surgery , Male , Middle Aged , Neoplasm Staging , Social Environment , Surveys and Questionnaires , Treatment Outcome , Voice QualityABSTRACT
The main elements of a medical hardware complex for speech signal research in patients with phonation disorders are considered. The complex is based on a model of human auditory system. It is shown that the complex can be used for speech recovery and diagnosis of the state of speech production apparatus.
Subject(s)
Diagnosis, Computer-Assisted/instrumentation , Speech , Voice Disorders/diagnosis , HumansABSTRACT
Combined therapy with preoperative course of remote neutron therapy was given to 29 patients with oral cavity cancer. All the patients had stage III of morphologically verified squamous cell carcinoma. Partial tumor regression after radiotherapy was observed in 39.5 +/- 8.9% patients. Complete regression was not achieved. There was no clear negative effect of preoperative course of remote therapy on the postoperative period in all patients. Local complications as wound edge disjunctions were registered in 13.4% of cases. On day 14-16 after surgery speech therapy rehabilitation was performed.
