R. Venkitaraman

Quality of Life following Total Laryngectomy: Assessment Using the UW-QOL Scale

Objectives: To determine the quality of life (QOL) in patients using valved speech following total laryngectomy with a validated patient self-report scale. Study Design: Cross-sectional cohort study. Patients: 63 patients following total laryngectomy using valved speech. Intervention: University of Washington Quality of Life (UW-QOL) questionnaire. Main Outcome Measures: Patient perception of the QOL over the last 7 days following total laryngectomy in response to specific questions and correlated with sociodemographic and treatment factors. Results: Responses were received from 44 males and 11 females (response rate: 87.3%) with a median age of 66 years (range: 40–84). The mean (SD) composite score of the QOL in our series of patients with total laryngectomy was 81.3 (10.9). As regards the overall QOL, 80% of our patients cited it as very good (45.5%) to good (34.5%). Patients identified speech, appearance, and activity as the most important issues following total laryngectomy. Only age and pharyngo-oesophageal segment closure were significant predictors of QOL scores (Student t test, p < 0.05) and not other demographic and treatment variables. Conclusions: The composite score and overall QOL were high in our series of total laryngectomy patients and this possibly reflects adequate multidisciplinary management. We strongly urge the use of prospective longitudinal studies that will adequately identify any QOL changes over time. Although the UW-QOL questionnaire is a simple and brief scale, it has limitations that can curtail its effective use in laryngectomy patients and we advise supplementing it with the use of domain-specific questionnaires.

Quality of life outcome measures following partial glossectomy: Assessment using the UW-QOL scale

BACKGROUND The consequences of a diagnosis of head and neck cancer and the impact of treatment have a clear and direct influence on well-being and associated quality of life (QOL) in these patients. AIMS To determine the QOL in head and neck cancer patients following a partial glossectomy operation. DESIGN AND SETTING Cross-sectional cohort study; Head and Neck Oncology Unit, tertiary referral center. MATERIALS AND METHODS 38 patients with partial glossectomy were assessed with the University of Washington head and neck quality of life (UW-QOL) scale, version 4. STATISTICAL ANALYSIS Statistical analysis was performed using the Statistical Package for Social Sciences 10.0 (SPSS Inc, Chicago version III). Information from the scale was correlated using the Mann Whitney test. A P value less than/equal to 0.05 was considered as significant. RESULTS The mean (sd) composite score of the QOL in our series was 73.6 (16.1). The majority (71.8%) quoted their QOL as good or very good. Swallowing (n = 16, 47.1%), speech (n = 15, 44.1%) and saliva (n = 15, 44.1%) were most commonly cited issues over the last 7 days. On the other hand, the groups with reconstruction, neck dissection, complications and radiotherapy demonstrated a significant reduction of quality of life scores (Mann Whitney test, P < 0.005). CONCLUSION The composite score and overall QOL as assessed using the UW-QOL scale (version 4) were modestly high in our series of partial glossectomy patients. Swallowing, speech, and saliva are regarded as the most important issues. Stage of the disease, neck dissection, reconstruction, complications, radiotherapy and time since operation were seen to significantly affect domain scores.

Multidimensional assessment of female tracheoesophageal prosthetic speech

Objective:  The objective of this study was to undertake a multidimensional assessment of female tracheoesophageal prosthetic speech.

Questionnaire analysis of swallowing-related outcomes following glossectomy

Objective: To determine the effects of a partial/total glossectomy on the swallow-related quality of life (QOL). Design: Cross-sectional, single-centre cohort study. Patients and Methods: Thirty-one patients who underwent partial/total glossectomy at our centre participated in the study. Main outcome was measured using the MD Andersen Dysphagia Inventory (MDADI) questionnaire. Results: Responses were received from 24 males and 7 females (response rate of 77.5%) with a median age of 50 years (range: 28–72). Median follow-up in patients was 33 months (range 4–210). The mean MDADI total score in our series of patients was 71.7 (SD 18.8). Mean MDADI global score was 64.5 (SD 29.1), mean Emotional score was 71.9 (SD 19.1), mean Functional score was 73.7 (SD 19.1) and mean Physical score was 69.3 (SD 21.7). Statistically significant differences were seen between the global, emotional and physical scores of patients who had received radiotherapy (Mann-Whitney, p < 0.05) and tracheostomy (functional score, Mann-Whitney, p = 0.038). Conclusion: The presence of tracheostomy tube and previous radiotherapy affects swallowing outcome in patients who have had surgery for squamous cell carcinoma of the tongue.

Questionnaire analysis of the swallowing‐related outcomes following total laryngectomy

Objective:  To determine the effects of a total laryngectomy on the swallow and subsequent quality of life in head and neck cancer patients.

Can objective parameters derived from videofluoroscopic assessment of post-laryngectomy valved speech replace current subjective measures? An e-tool-based analysis

Objectives:  The primary purpose of this study was to assess the pharyngoesophageal segment in total laryngectomy patients using a videofluoroscopy e‐tool.

Childhood papillary thyroid cancer as second malignancy after successful treatment of rhabdomyosarcoma

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Is electroglottography-based videostroboscopic assessment of post-laryngectomy prosthetic speech useful?

OBJECTIVES To use an electroglottography (EGG)-based videostroboscopy tool to assess the anatomical and morphologic characteristics of the pharyngoesophageal (PE) segment in tracheoesophageal (TO) speakers. STUDY DESIGN Cross-sectional cohort study. SUBJECTS Fifty-two post-laryngectomy patients with no recurrence and using prosthetic (Blom-Singer) speech. INTERVENTION An electroglottography (EGG)-based videostroboscopy tool EGG-based rigid videostroboscopy as well as perceptual evaluation. OUTCOME MEASURES Stroboscopic protocol included nine subjective/visual parameters to evaluate the neoglottis and study correlation of the G (GRBAS scale) and the overall voice quality (OVQ) with the treatment variables. RESULTS Of the 52 laryngectomees, videostroboscopic recordings were possible in 46 patients (36 males and 10 females) with a mean age of 63.4 +/-10.5 (SD) an electroglottography (EGG)-based videostroboscopy tool years. All used the Blom-Singer valve and the median time since Total Laryngectomy was 2 years. The neoglottis was assessable in 26 patients. We were able to strobe only 9 patients. There was excellent correlation between G and OVQ (Spearman rho > 0.9). Statistically significant correlation was found between G1 and saliva (P = 0.03) and between good OVQ and saliva (P = 0.02); similarly, there was significant correlation between G1 and LVV (P = 0.05) and between good OVQ and LVV (P = 0.03). CONCLUSIONS This study is the first to examine the use of an EGG-based stroboscopy instrument to evaluate TO speech. Our observations suggest that from the standpoint of functional voice, saliva and the LVV had statistically significant effect in determining voice quality.

Does flexible videostroboscopy compare with rigid videostroboscopy in the assessment of the neoglottis? A preliminary report

Objective:  To evaluate rigid and flexible stroboscopy of the neoglottis.