[Voice-related quality of life vs. health-related quality of life after partial laryngectomy]. / Stimmbezogene und allgemeine gesundheitsbezogene Lebensqualität kehlkopfteilresezierter Patienten.

BACKGROUND: The assessment of the treatment results of laryngeal cancer includes subjective aspects. Two tools for assessment of the quality of life of patients after treatment of small laryngeal carcinoma were compared: The disease-unspecific short-form-36 health-survey (SF-36) and the specific voice-related-quality-of-life-questionnaire (V-RQOL). MATERIAL AND METHODS: Data of 65 patients after partial laryngeal resection was evaluated during regular out clinic examinations. RESULTS: The average V-RQOL total score was 70,0 ± 24,3. Similar results were achieved for the physically (68,2 ± 24,3) and for the emotional (72,5 ± 27,6) subscores of the V-RQOL-survey being lower than the cut-off for healthy voices, which is at 80 points. The SF-36-health survey score was 43,0 ± 10,7 for the physically subscore and 50,2 ± 9,1 for the emotional subscore. Both subscores were rated worse than the age-adjusted standard value for the SF-36. There is a moderate correlation between both questionnaires, which does not depend from the size of the laryngeal carcinoma (T1 or T2). CONCLUSION: The voice-related quality of life is part of the health-related quality of life next to other factors. An amelioration of voice-related quality of life thus should lead to better general, health-related quality of life.

Voice handicap index and voice-related quality of life in small laryngeal carcinoma.

Laryngeal cancer can affect the patients' voice. For assessment of the patients' self-perception of their voice, several tools were introduced into clinical routine. The voice handicap index questionnaire (VHI) is regarded as the "gold standard". However, in benign laryngeal pathologies and in functional dysphonia, the shorter voice-related quality of life questionnaire (V-RQOL) proved to be equivalent. This study examines the correlation of both questionnaires in patients who had been treated for small (T1 and T2) laryngeal cancer. It was performed during regular outclinic examinations. In total, 65 patients aged 62.1 ± 10.0 years completed the German versions of the VHI and V-RQOL. Their average VHI total score was 38.9 ± 26.0 points and the average V-RQOL score was 70.1 ± 24.4%. The total scores correlated with |ρ| = 0.92 and p < 0.01. Both questionnaires give quasi identical results, the shorter V-RQOL may be favoured for clinical application.

[Speech intelligibility degree and coping after multimodal therapy of oral squamous carcinoma]. / Sprachverständlichkeit und Krankheitsverarbeitung nach der Therapie von Mundhöhlenkarzinomen.

BACKGROUND: Multimodal treatment of oral cancer can cause speech disorders and diminish speech intelligibility. Speech intelligibility is an essential part of social interaction and therefore important for coping with the disease. The aim of this study was to investigate the influence of speech intelligibility on coping strategies and a standardized questionnaire. PATIENTS AND METHODS: Speech recordings from 76 patients 60.7 ± 11.4 years old (19 women, 57 men) were performed at least 6 months after multimodal treatment of T1-T4 squamous cell carcinoma of the oral cavity and evaluated by automatic speech recognition. Speech intelligibility was quantized as correctly recognized words of a standard text (word recognition rate WR). Coping was evaluated by the Trier Scales of Coping Strategies via questionnaires. RESULTS: Speech intelligibility scores WR rated between 22.2% and 84.3% (mean value 54.2 ± 15.7). Coping strategies vary considerably between the patients and between the scales. WR and the Trier Scales significantly correlate in 3 of the 5 categories (Rumination, Search for Information and Exchange of Experiences). CONCLUSION: Reduced speech intelligibility after multimodal treatment of oral cancer is associated with a change of coping strategy. This includes not only communication-based strategies (Search for Information and Exchange of Experiences) but also intra-psychic processes like rumination.