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SUMMARY OBJECTIVE: Therapy and vocal rehabilitation in laryngeal cancer impact patients' quality of life. The objective of this study was to evaluate the evolution of the quality of life of patients with laryngeal cancer submitted to total laryngectomy and using electrolarynx. METHODS: This is an observational study with a cross-sectional design and a quantitative approach. It was conducted between April 2022 and January 2023 in a Brazilian cancer hospital. For data collection, a quality of life questionnaire, validated for patients with head and neck cancer at the University of Washington, was applied in two phases: from 7 days after total laryngectomy and, subsequently, from 70 days after surgery using electronic larynx for at least 60 days. The inclusion criteria were patients undergoing total laryngectomy included on the Aldenora Bello Cancer Hospital's election list to receive the electronic larynx. Patients who did not sign the informed consent form were not included. RESULTS: The sample consisted of 31 patients, of which approximately 84% were men and approximately 93% at the age of 50 years or older. When comparing the phases, it is possible to observe that the item speech had the greatest progress, while chewing had the least. Only the item recreation, swallowing, taste, and saliva did not show any statistical significance. The score for the general quality of life questions increased. CONCLUSION: Electronic larynx is a viable and useful method of voice rehabilitation. Our data suggest that the use of the electrolarynx as a postlaryngectomy method of verbal communication is responsible for positive effects on patients' quality of life.
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BACKGROUND: Communication adjustment from patients' perspective is paramount to ensure optimization of voice rehabilitation post laryngectomy. Very few specific self-rating tools exist with the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) having the most evidence regarding validity, reliability and clinical utility. OBJECTIVES: This study aimed to translate and validate a Bahasa Malaysia version of SECEL (mSECEL) using a validated framework of transcultural adaptation. METHODS: This cross-sectional study was conducted in the Otorhinolaryngology, Department of Universiti Kebangsaan Malaysia Medical Centre from February 2019 to May 2020. The mSECEL was produced following a rigorous forward and backward translation. Eighty-three laryngectomees (78 male, five female) using various methods of alaryngeal communication (47 voice prosthesis, 29 electrolarynx, three esophageal speech and four pen and paper), completed the mSECEL and mVHI-10 before head and neck and flexible laryngoscopic examinations. The mSECEL was repeated in 2 weeks via telephone interview or clinic visit. Its reliability was assessed using intraclass correlation. The Pearson product-moment correlation test was used to analyze correlation between the mSECEL and mVHI-10. RESULTS: The mSECEL questionnaire showed strong internal consistency with the Cronbach alpha of >0.90 for total score, Environmental and Attitude subscale. The test-retest reliability for total mSECEL score was high with the intraclass correlation of 0.97. There was a highly significant positive correlation between the mSECEL total score and mVHI-10 (P < 0.001). Items in the General subscale showed poorer internal consistency with Cronbach alpha ranging 0.55-0.46 and poor correlation with mVHI-10. CONCLUSIONS: The Bahasa Malaysia version of the SECEL measure is a valid and reliable instrument to evaluate communication perception after laryngectomy. Future studies should consider subscale validation and further abbreviation of its items to make this measure clinically relevant.
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Diagnostic Self Evaluation , Laryngectomy , Humans , Male , Female , Laryngectomy/methods , Malaysia , Cross-Sectional Studies , Reproducibility of Results , Communication , Surveys and QuestionnairesABSTRACT
OBJETIVO: avaliar através da eletromiografia de superfície o comportamento dos músculos esternocleidomastóideo e paraespinhais cervicais bilateralmente em pacientes que se comunicam por meio da fala esofágica e laringe artificial, para determinar se o tipo de voz utilizada altera o comportamento dos músculos cervicais. MÉTODOS: foram avaliados dez voluntários (duas mulheres e oito homens), idade média de 49,7 anos, com laringectomia total, tempo de pós-operatório médio de 2,6 anos, com limitação dos movimentos do pescoço, divididos em dois grupos: grupo 1: cinco voluntários (laringe artificial); grupo 2: cinco voluntários (voz esofágica); grupo 3 controle (sete voluntários). RESULTADOS: na fonação não houve alteração no padrão de ativação muscular dos indivíduos que utilizam a voz esofágica e a laringe artificial, com relação ao grupo controle. No entanto, na condição de repouso houve diferença significativa, comparando-se os valores médios de Root Mean Square dos grupos 1 e 2 com o grupo 3, para o músculo esternocleidomastóideo direito e para os músculos paraespinhais cervicais direito. CONCLUSÃO: o tipo de opção vocal não interferiu no padrão de ativação muscular durante a fonação, bem como não existiu diferença no padrão de ativação muscular na fonação dos voluntários quando comparados a indivíduos sem intercorrências no aparelho fonador.
PURPOSE: to evaluate by the surface electromyography the behavior of the sternocleidomastoid and cervical paraspinalis muscles, bilaterally in patients who use esofagic and artificial larynx as alternative to talk and to determine if these conditions modify the cervical muscles behavior. METHODS: ten volunteers were evaluated (two women, eight men), with average age: 49. 7 years, with total laryngectomy, average time of postoperative: 2.6 years, with neck movements limitation, divided in two groups: group 1 with five volunteers (artificial larynx); group 2 with five volunteers (esofagic voice); and group 3 control (seven volunteers). RESULTS: there was no significant difference in the muscular activation pattern during phonation in individuals with esofagic voice and the artificial larynx compared to the control group, however, in the rest condition, there was a significant difference comparing the average values of Root Mean Square (RMS) of groups 1 and 2 with group 3, for the right sternocleidomastoid muscle and the right cervical paraspinalis muscles. CONCLUSION: the vocal option did not interfere on the muscular activation pattern during the phonation, as well as there was no difference in the muscular activation pattern comparing the experimental groups with the control group.
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0.05). There were no significant differences in sound, maximum sound intensity, breath sessions, base frequency and amplitude between the patients using artificial larynx and control group, but there were significant difference in fundamental frequency perturbation, amplitude perturbation, standardized noise energy and harmonious noise ratio(P
