doiSerbia

Quality of life of laryngectomized patients in Serbia

Krejović-Trivić Sanja (Clinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade + Faculty of Medicine, Belgrade)
Milovanović Jovica (Clinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade + Faculty of Medicine, Belgrade)
Parapid Biljana (Faculty of Medicine, Belgrade + Clinical Centre of Serbia, Division of Cardiology, Belgrade)
Vukašinović Milan (Clinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade)
Miković Nikola (School of Dental Medicine, Clinic for Maxillofacial Surgery, Belgrade)
Trivić Aleksandar (Clinical Centre of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade + Faculty of Medicine, Belgrade)

Introduction/Objective. Total laryngectomy is a very mutilating operation and it leads to drastic changes in life quality. The purpose of this study was to examine factors of importance to the laryngectomized patients’ quality of life and to evaluate characteristics of esophageal voice and speech. Methods. The study was conducted at the Clinic of Otorhinolaryngology and Maxillofacial Surgery, at the Clinical Center of Serbia (Belgrade, Serbia), during the period between March 2012–2015. The study included 223 patients diagnosed with laryngeal cancer, who underwent total laryngectomy. The total of 168 laryngectomized patients were provided with phoniatric rehabilitation. Results. The quality of life was significantly better for those laryngectomized patients who did undergo phoniatric rehabilitation. By means of intensive phoniatric rehabilitation the esophageal voice and speech was established in 86.3% of laryngectomized patients registered by objective acoustic analysis. Rehabilitated laryngectomy patients had a significantly lower presence of voice handicap sense (VHI: 19.57 Ѓ} 7.35) and expressed significantly lower symptoms of depression and anxiety (PHQ-9: 3.8 Ѓ} 4.2; GAD-7: 3.4 Ѓ} 4.2). Cronbach’s alpha coefficient was above 0.7 EORTC QLQ-C30 on three levels of Likert scales: the scale of physical and emotional functioning and fatigue; as well as EORTC QLQ-H&N43 questionnaire: the symptoms of head and neck pain, speech, swallowing and eating problems and body image. Conclusion. Significantly improving the quality of life of laryngectomized patients was achieved by a multidisciplinary rehabilitation. Phoniatric rehabilitation carried out in a planned and systematic way is the most efficient rehabilitation of laryngectomized patients.

Keywords: quality of life, total laryngectomy, esophageal voice and speech, phoniatric rehabilitation