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1.
Laryngorhinootologie ; 86(12): 867-74, 2007 Dec.
Article in German | MEDLINE | ID: mdl-17713877

ABSTRACT

BACKGROUND: Often it is assumed that psychosocial and sociodemographic factors cause the success of voice rehabilitation after laryngectomy. Aim of this study was to analyze the association between these parameters. METHODS: Based on tumor registries of six ENT-clinics all patients were surveyed, who were laryngectomized in the years before (N = 190). Success of voice rehabilitation has been assessed as speech intelligibility measured with the postlaryngectomy-telephone-intelligibility-test. For the assessment of the psychosocial parameters validated and standardized instruments were used if possible. Statistical analysis was done by multiple logistic regression analysis. RESULTS: Low speech intelligibility is associated with reduced conversations (OR 0.970) and social activity (OR 1.049). Patients are more likely to talk with esophageal voice when their motivation for learning the new voice was high (OR 7.835) and when they assessed their speech therapist as important for their motivation (OR 4.794). The risk to communicate merely by whispering is higher when patients live together with a partner (OR 5.293), when they talk seldomly (OR 1.017) and when they are not very active in social contexts (OR 0.966). CONCLUSIONS: Psychosocial factors can only partly explain how voice rehabilitation after laryngectomy becomes a success. Speech intelligibility is associated with active communication behaviour, whereas the use of an esophageal voice is correlated with motivation. It seems that the gaining of tracheoesophageal puncture voice is independent of psychosocial factors.


Subject(s)
Laryngeal Neoplasms/surgery , Laryngectomy/rehabilitation , Larynx, Artificial , Social Adjustment , Speech Intelligibility , Speech, Alaryngeal , Speech, Esophageal , Adult , Aged , Aged, 80 and over , Communication , Cross-Sectional Studies , Female , Humans , Laryngectomy/psychology , Larynx, Artificial/psychology , Male , Middle Aged , Motivation , Quality of Life/psychology , Social Behavior , Speech Production Measurement , Speech, Alaryngeal/psychology , Speech, Esophageal/psychology , Telephone , Verbal Behavior
2.
Rehabilitation (Stuttg) ; 46(6): 356-62, 2007 Dec.
Article in German | MEDLINE | ID: mdl-18188807

ABSTRACT

AIMS: This study is directed at the following questions: How many laryngectomees are using which adaptive devices how often? Which devices are they lacking? Which alaryngeal voice has the best results in terms of intelligibility? METHODS: 218 patients operated on in 6 ENT-clinics in Eastern Germany over the last 25 years were interviewed in person. Items from a German questionnaire for psychosocial adjustment after laryngectomy (FPAL) and from the quality of life questionnaire EORTC QLQ-H&N35 were used. Voice intelligibility was measured by an objective test, the Postlaryngectomy-Telephone-Intelligibility-Test (PLTT). RESULTS: The most common communication method in this group is the esophageal voice, only 20% use voice prostheses regularly, and 15% of the patients use electronic devices. 87% of the laryngectomees wear scarves to protect their stoma, and 82% use inhalers. Several patients lack tools for communication, some for protection of the tracheostoma and others devices for showering and swimming. The best speech results are gained with voice prostheses. Health related Quality of Life shows only poor correlation with the use of adaptive devices. CONCLUSION: In general the health care for laryngectomees in terms of device use can be seen as relatively good but not as optimal. Problematic is the fact that 15.5% of the patients could not acquire an adequate voice, that some devices are missed by patients despite the fact that they are available for purchase, and that some patients do not care for their tracheostoma. It could be useful to consider these findings within medical consultations.


Subject(s)
Laryngectomy/rehabilitation , Larynx, Artificial/statistics & numerical data , Speech, Alaryngeal , Speech, Esophageal , Adult , Aged , Aged, 80 and over , Female , Germany , Humans , Laryngectomy/psychology , Larynx, Artificial/psychology , Male , Middle Aged , Quality of Life , Social Adjustment , Speech Intelligibility , Speech, Alaryngeal/psychology , Speech, Esophageal/psychology , Utilization Review
3.
HNO ; 54(6): 477-80, 2006 Jun.
Article in German | MEDLINE | ID: mdl-16041518

ABSTRACT

In this case report an artificial disorder with symptoms of chronic otitis media and progressive hearing loss is described. This represents a rare case of Munchausen syndrome. The difficulties in diagnosis and therapy are shown by the development of the disease, produced by self damaging activities.


Subject(s)
Hearing Loss/diagnosis , Hearing Loss/therapy , Munchausen Syndrome/diagnosis , Munchausen Syndrome/therapy , Otitis Media with Effusion/diagnosis , Otitis Media with Effusion/therapy , Self-Injurious Behavior/diagnosis , Adult , Female , Hearing Loss/psychology , Humans , Munchausen Syndrome/psychology , Otitis Media with Effusion/psychology , Self-Injurious Behavior/prevention & control , Self-Injurious Behavior/psychology , Treatment Outcome
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