Evaluation of Surgical and Functional Outcomes of Supracri- coid Laryngectomy and Rehabilitation Protocols.

ABSTRACT: Laryngeal squamous cell carcinoma (LSCC) is the most common malignant neoplasms of the head and neck. Several treatment options exist for LSCC according to cancer location and stage at diagnosis; proposed treatments include surgery alone or in combination with chemotherapy and radiotherapy. In selected LSCC cases in the T2-T4 staging, supracricoid laryngectomy (SCL) is an organ-sparing surgical approach aimed at preserving the main laryngeal functions that has been proposed as an alternative to total laryngectomy. Rehabilitation for swallowing and respiratory functions plays a central role after SCL; functional outcomes after SCL may significantly vary among different centers but they are generally satisfactory when oncological radicality has been obtained and the rehabilitation protocol starts promptly. In this clinical review, we analyzed functional outcomes for swallowing and voice rehabilitation in patients after SCL, as well as the optimal SCL surgical technique, post-operative complications and comparison with total laryngectomy or radio-chemotherapy protocols.

Long-term functional and quality of life outcomes in laryngectomized patients after successful voice restoration using tracheoesophageal prostheses.

OBJECTIVE: To assess long-term functional and quality of life (QoL) outcomes and their predictive factors in laryngectomized patients after successful voice restoration using tracheoesophageal prostheses (TEP). METHODS: This cross-sectional study was conducted in alive and disease-free patients at least 1 year after total laryngectomy ± partial pharyngectomy. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core (QLQ-C30) and Head and Neck Cancer (QLQ-H&N35) QoL questionnaires, the Voice Handicap Index (VHI-10) questionnaire and the Hospital Anxiety and Depression Scale (HADS). The level of dysphagia was evaluated using the Dysphagia Handicap Index (DHI) and the Dysphagia Outcomes and Severity Scale (DOSS). Predictive factors of these clinical outcomes were determined in univariate and multivariate analysis. RESULTS: A total of 48 patients were included in this study. Long-term QoL and functioning scales scores were all superior to 70%. Main persistent symptoms were fatigue, dyspnea, senses, speech and coughing problems. A DOSS score ≥6, indicating normal/subnormal swallowing function, and a VHI-10 score ≤20, representing light to medium voice disorders, were found in at least 75% of patients. An anxiodepressive disorder (HADS global score ≥ 15) was reported by 15 (31%) patients and represented the main predictor of QoL and voice outcomes. A strong correlation was found between VHI-10 and global QoL scores. CONCLUSIONS: After successful voice restoration, laryngectomized patients achieved satisfactory QoL and functional outcomes. Psychological distress was the main determinant of long-term QoL and is therefore of critical importance in the multidisciplinary management of laryngectomized patients.

Oncological and Functional Outcomes of Primary and Salvage Total Laryngectomy.

OBJECTIVES: To evaluate and compare the oncological and functional outcomes of total laryngectomies (TL) performed as first line treatment or for salvage after failure of conservative approaches for treating advanced laryngeal carcinoma (LSCC). STUDY DESIGN: A retrospective cohort study. METHODS: A cohort of 217 patients who underwent TL was divided according to whether the procedure was for primary treatment of their LSCC (101 patients) or for recurrences after conservative surgery or chemo-radiotherapy (116 patients). RESULTS: The overall survival rate and disease-specific survival rate were significantly higher in the primary TL group than in the salvage TL group (P = .04 and P = .01, respectively). The recurrence rate was significantly higher and the disease-free survival (in months) was shorter for patients who had salvage TL than for those who had primary TL (P = .00 and P = .01, respectively). The salvage TL group also included significantly more cases of postoperative pharyngo-cutaneous fistula needing salivary stent positioning, and experienced significantly longer hospital stays than the primary TL group (P = .04 and P = .03, respectively). CONCLUSION: Oncological and functional outcomes of primary TL were significantly better than after salvage TL. If salvage TL was performed after conservative surgery had failed, the oncological and functional results were better than after the failure of organ-preserving protocols. This could justify a first attempt at conservative surgery for intermediate-advanced LSCC in selected cases, reserving chemo-radiotherapy only for patients unsuitable for surgery. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E569-E575, 2021.

Cost-effectiveness analysis of voice rehabilitation for patients with laryngeal cancer: a randomized controlled study.

INTRODUCTION: Voice problems are common following radiotherapy for laryngeal cancer. Few studies exist covering the effect of voice rehabilitation, and no previous studies exist regarding the cost of said rehabilitation. This randomized controlled study aimed to analyze the cost-effectiveness of voice rehabilitation after radiotherapy for patients with laryngeal cancer. MATERIAL AND METHODS: A total of 66 patients with laryngeal cancer with follow-up data 12 months post-radiotherapy were included. Patients were randomized into receiving either voice rehabilitation (n = 32) or no voice rehabilitation (n = 34). The patient outcome was measured as quality-adjusted life years (QALYs). The index range between 0 and 1, where 0 equals death and 1 represents perfect health. The QALYs were assessed with the European Organization for Research and Treatment of Cancer questionnaire QLQ-C30 mapped to EuroQoL 5 Dimension values. The cost of rehabilitation and other healthcare visits was derived from hospital systems. The patients reported the total amount of sick leave days during the first 12 months following radiotherapy. The cost-effectiveness of the voice rehabilitation was compared with no rehabilitation intervention based on the incremental cost-effectiveness ratio. RESULTS: The cost per gained QALY with voice rehabilitation compared to no rehabilitation from a societal perspective was - 27,594 € (SEK - 250,852) which indicates that the voice rehabilitation is a cost-saving alternative compared to no rehabilitation due to lower costs and a slightly better health outcome. From a healthcare perspective, the voice rehabilitation indicates a cost 60,800 € (SEK 552,725) per gained QALY. CONCLUSION: From a societal perspective, i.e., including the costs of production loss, voice rehabilitation compared to no voice rehabilitation following radiotherapy for laryngeal cancer seems to be cost-saving. When analyzing only the healthcare costs in relation to health outcomes, voice rehabilitation indicates an incremental cost of 60,800 € per gained QALY, which is just above the threshold of the maximum willingness to pay level.

Rehabilitation following open partial laryngeal surgery: key issues and recommendations from the UK evidence based meeting on laryngeal cancer.

BACKGROUND: It is recognised that a limited cohort of patients receive open partial laryngeal surgery in specific centres within the UK, so sharing information around key clinical issues and recommendations for practice is necessary to improve outcomes. METHODS: This position statement provides practice recommendations based on a synthesis of the available evidence presented at the 12th Evidence Based Management day on 'Laryngeal Cancer' and the ensuing discussions. Literature searches and critical analysis of available evidence were undertaken and triangulated with the clinical experience of the authors to develop these recommendations.Results and conclusionThis paper presents a comprehensive overview of challenges that the multidisciplinary team may encounter. It provides recommendations for swallow and speech rehabilitation after open partial laryngectomy, and suggests practical ways that these issues may be addressed pre- and post-operatively.

Postlaryngectomy prosthetic voice rehabilitation outcomes in a consecutive cohort of 232 patients over a 13-year period.

BACKGROUND: With the increasing necessity for total laryngectomy (TL) after prior (chemo)radiotherapy, prosthetic vocal rehabilitation outcomes might have changed. METHODS: Retrospective cohort study including all patients laryngectomized between 2000 and 2012 with a voice prosthesis (VP) in the Netherlands Cancer Institute. RESULTS: Median device lifetimes of the standard Provox2 and Vega VPs are 63 and 66 days, respectively, and for the problem-solving ActiValve Light and Strong VPs 143 and 186 days, respectively. In multivariable analysis, salvage TL and TL for a dysfunctional larynx (compared to primary TL) were associated with a shorter device lifetime. Almost half of the patients (48%) experienced tracheoesophageal puncture tract-related problems, and this concerned 12% of all VP replacements. CONCLUSIONS: Compared to historical cohorts, device lifetimes of regular Provox2 and Vega voice prostheses have decreased. Complications are not occurring more frequently but affect more patients. Nevertheless, the clinical reliability and validity of prosthetic voice rehabilitation is still sound.

French Therapeutic Education Programme Aimed at Improving the Quality of Life of Laryngectomised Patients and their Close Relations: the Three Stages (Observational and Interventional Randomised) of the Study "PETAL".

The therapeutic education of patients and their close relations is, as yet, poorly developed in France in the field of oncology. Total laryngectomy is a mutilating surgical procedure having a major impact on the patient's life, due to its physical and functional sequelae. Its psychosocial consequences are also important and alter the quality of life of patients and their close relations. Currently, care for laryngectomised patients consists essentially in informing and educating them on some technical procedures during hospital admission. The intervention of a speech therapist, often serves as the link between the patient and the hospital care team. These healthcare modalities often insufficiently account for the social, environmental and personal factors that interact in health-related problems. This report presents the therapeutic education programme protocol "PETAL" for laryngectomised patients and their close relations to improve their quality of life. The trial will be conducted over three phases: (1) the "pilot" phase aims at developing knowledge on the consequences of laryngectomy on the quality of life of patients and their close relations and developed a pluridisciplinary therapeutic education program, (2) the prospective intervention "replication" phase aims at evaluating the programme's transferability in three centres and (3) the cluster-randomised multicentric comparative intervention phase, will assess the benefits of the developed programme. Phase I identified nine themes of workshops related to therapeutic education, training and coordination of care. The developed programme should reinforce town-hospital links to improve help, follow-up and support for patients and their close relations.

The Treatment of Laryngeal Cancer.

Successful management of laryngeal cancer depends on careful pretreatment evaluation of patient and disease factors to arrive at accurate staging, leading to appropriate treatment selection for patients with this highly impacting disease. Surgical modalities, including transoral laser microsurgery, open partial laryngectomy, and total laryngectomy, offer options, alone or in combination with radiation and chemotherapy. Treatment strategy for laryngeal cancer should strive for cure while maintaining the best quality of life possible for the patient. Achieving the goals of initial and salvage treatment for laryngeal cancer depends on executing a plan of care determined by the expertise of the multidisciplinary team.

Unmet supportive care needs in patients treated with total laryngectomy and its associated factors.

BACKGROUND: The purpose of this study was to investigate unmet supportive care needs in patients treated with total laryngectomy and its associated factors. METHODS: In this cross-sectional study, 283 patients who underwent total laryngectomy completed questions on supportive care needs (Supportive Care Needs Survey [SCNS]). Median time since total laryngectomy surgery was 7 years (range 0-37 years). The prevalence of unmet supportive care needs and its associated factors were investigated using logistic regression analyses. RESULTS: Unmet supportive care needs were highest for the head and neck cancer-specific functioning domain (53%), followed by the psychological (39%), physical and daily living (37%), health system, information, and patient support (35%), sexuality (23%), and lifestyle (5%) domains. Seventy-one percent reported at least one low, moderate, or high unmet need. Female sex, living alone, and having a voice prosthesis were positively associated with unmet needs on 1 domain (P < .05). A worse health-related quality of life was associated with unmet needs on all domains. CONCLUSION: The majority of patients who underwent total laryngectomy report at least one low, moderate, or high unmet supportive care need.

Mecanismos de comunicación en pacientes laringectomizados / Communication mechanisms in laringectomized patients

RESUMEN El cáncer laríngeo representa el 25% de las neoplasias de cabeza y cuello. Para los carcinomas laríngeos T1 tratados con radioterapia o cirugía láser, no existe diferencia significativa en cuanto a la calidad de voz percibida por el paciente entre ambas formas terapéuticas. La laringectomía total sigue siendo utilizada como la alternativa terapéutica en carcinomas avanzados. La pérdida de la capacidad de fonación es una consecuencia de esta cirugía, por lo que existe un variado abanico de mecanismos de comunicación que ofrecerle al paciente. Las alternativas clásicas comprenden: erigmofonación, laringe electrónica y válvula traqueoesofágica. Dentro de este escenario, han surgido nuevas alternativas en los últimos años como son conversión estadística de voz GMM (Gaussian Mixture Model), proyecto SWARA y el proyecto "Mi propia voz".

ABSTRACT Laryngeal cancer accounts for 25% of head and neck cancers. For T1 laryngeal carcinomas treated with radiotherapy or laser surgery, there is no significant difference in terms of quality of voice perceived by the patient between both therapeutic forms. The total laryngectomy is still used as the therapeutic alternative in advanced carcinomas. The loss of the phonation ability is a consequence of the surgery, so there is a diverse range of communication mechanisms to offer to the patient. Classical approaches include: esophageal speech, electrolarynx and tracheoesophageal valve. In this scenario, new alternatives have emerged: statistical voice conversion GMM (Gaussian Mixture Model), SWARA project and "Mi propia voz" project.

Rehabilitación vocal en un paciente con cáncer de laringe tratado con radioterapia / Vocal rehabilitation in a patient with laryngal cancer treated with radiotherapy / Reabilitação vocal em paciente com câncer de laringe tratado com radioterapia

INTRODUCCIÓN: La mayoría de la población con cáncer de laringe experimenta alteraciones persistentes en la voz por causa de los efectos fisiopatológicos de la radioterapia, provocando un gran impacto a nivel funcional y psicosocial. Los objetivos son: Determinar los momentos de la intervención fonoaudiológica en pacientes con cáncer de laringe tratados con radioterapia, describir la metodología de evaluación clínica y objetiva de la función fonatoria, identificar los factores que colaboran en la mejoría de la calidad vocal, comunicación y calidad de vida del paciente. MATERIAL Y MÉTODO: Diseño: Caso clínico. Paciente femenino, de 78 años con diagnóstico de carcinoma escamoso moderadamente diferenciado, infiltrante de laringe EI (T1bN0M0). Realizó radioterapia de intensidad modulada. Entrevista pre e intratratamiento, postratamiento de radioterapia y rehabilitación vocal propiamente dicha. Estudio objetivo de la voz (PRAAT). Valoración perceptual de la voz (GRBAS). Encuesta de calidad de vida (VHI).

INTRODUCTION: The majority of the population with laryngeal cancer experiences persistent alterations in the voice because of the pathophysiological effects of radiotherapy, provoking a great impact at functional and psychosocial level. The objectives are to determine the moments of the speech-language intervention in patients with laryngeal cancer treated with radiotherapy, describe the methodology of clinical and objective evaluation of phonatory function, identify the factors that contribute to the improvement of vocal quality, communication and quality of life of the patient. MATERIAL AND METHOD: Design: Clinical case. Female patient, 78 years old with diagnosis of moderately differentiated squamous carcinoma, infiltrating larynx EI (T1bN0M0). She performed modulated intensity radiotherapy. Pre and intra-treatment interview, post-treatment of radiotherapy and vocal rehabilitation proper. Objective study of voice (PRAAT). Perceptual perception of voice (GRBAS). Quality of Life Survey (VHI).

INTRODUÇÃO: A maioria da população com câncer de laringe sofre alterações persistentes na voz devido aos efeitos fisiopatológicos da radioterapia, causando um grande impacto no nível funcional e psicosocial. Os objetivos são determinar os momentos da intervenção fonoaudiológica em pacientes com câncer de laringe tratados com radioterapia, descreva a metodologia de avaliação clínica e objetiva da função fonatória, identificar os fatores que contribuem para a melhoria da qualidade vocal, comunicação e qualidade de vida do paciente. MATERIAL E MÉTODO: Design: Caso clínico. Paciente do sexo feminino, 78 anos com diagnóstico de carcinoma escamoso moderadamente diferenciado, infarto da laringe EI (T1bN0M0). Eu executo radioterapia de intensidade modulada. Entrevista pré e intra-tratamento, pós-tratamento de radioterapia e reabilitação vocal própria. Estudo objetivo da voz (PRAAT). Percepção perceptiva da voz (GRBAS). Inquérito à qualidade de vida (VHI)

Insertion of a tracheoesophageal speech valve: a novel approach in a difficult situation.

BACKGROUND: Functional voice rehabilitation is becoming increasingly important following total laryngectomy and pharyngolaryngectomy. Tracheoesophageal voice via a shunt valve is currently regarded as the 'gold standard' for voice rehabilitation. Traditional techniques usually allow for the replacement of valves in the out-patient setting; however, patient factors such as altered anatomy may occasionally prevent this. OBJECTIVE: This paper describes a novel approach for speech valve insertion that is safe, quick and cost-effective, and which uses equipment commonly available in ENT wards and the operating theatre.

Device Life of the Tracheoesophageal Voice Prosthesis Revisited.

Importance: Voice prosthesis (VP) device life is a limiting factor of tracheoesophageal (TE) voice restoration that drives patient satisfaction, health care costs, and overall burden. Historic data suggest that TE VPs have an average device life of generally 3 to 6 months, but these data are typically derived from small samples using only 1 or 2 devices. Objective: To reexamine current device life in a large, contemporary cancer hospital in the United States that uses a wide assortment of VPs. Design, Setting, and Participants: This retrospective observational study included 390 laryngectomized patients with a tracheoesophageal puncture (TEP) who had VP management at MD Anderson Cancer Center between July 1, 2003, and December 31, 2013. Main Outcomes and Measures: Tracheoesophageal voice-related outcomes were: (1) device life duration to VP removal, and (2) treatment-related and prosthetic-related factors influencing device failure. Primary independent variables included treatment history (extent of surgery and radiation history), VP type (indwelling vs nonindwelling, size, specialty features), and reason for removal (leakage, complication, other). Duration was examined using Kaplan-Meier analysis. Disease, treatment, and patient-specific factors were analyzed as predictors of duration. Results: Overall, 3648 VPs were placed in the 390 patients (median [range] age, 62 [34-92] years). Indwelling prostheses accounted for more than half (56%) of the devices placed (55%, 20-Fr diameter; 33%, 8-mm length). More than two-thirds (69%) of prostheses were removed because of leakage, while the rest were removed for other reasons. Median device life was 61 days for all prostheses. Indwelling and nonindwelling VPs had median device lives of 70 and 38 days, respectively. There was no significant difference between specialty prostheses compared with standard devices (median duration, 61 vs 70 days, respectively). The Provox ActiValve (Atos Medical) had the longest life. Neither radiation therapy nor extent of surgery had a meaningful impact on device life. Conclusions and Relevance: Our data suggest that VP duration demonstrates a lower durability than historically reported. This may reflect the intensification of treatment regimens that complicate TEP management in an era of organ preservation; however, further investigation is needed.

Interpretation of the Swedish Self Evaluation of Communication Experiences after Laryngeal cancer: Cutoff levels and minimum clinically important differences.

BACKGROUND: The purpose of this study was to establish minimum clinically important difference (MCID) scores for the Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer (S-SECEL) in order to facilitate clinical interpretation and identify cutoff values for voice rehabilitation. METHOD: One hundred nineteen patients with laryngeal cancer completed the S-SECEL instrument and an anchor question regarding acceptability of speech in a social context pretreatment and 12-month postoncologic treatment. Receiver operating characteristic (ROC) curves analysis was used for calculation of cutoff values. RESULTS: Voice rehabilitation cutoff values were identified for all domains (Total = 20; General = 4; Environmental = 16, and Attitudinal = 5), presenting acceptable sensitivity and specificity. Initial MCID estimates were obtained for all domains; improvement of -13 points (p < .0001) or a deterioration of +8 points (p = .035) for the Total domain. CONCLUSION: MCID and cutoff scores for the S-SECEL have been identified and may be used in clinical practice to help identify patients with laryngeal cancer in need of voice rehabilitation.

Modeling of pharyngoesophageal segment during tracheoesophageal phonation in total laryngectomy patients with preliminary validation.

For patients with large or recurrent laryngeal cancer, total laryngectomy surgery is usually performed. In the absence of a larynx, tracheoesophageal (TE) voice is the gold standard for alaryngeal phonation. The mechanisms underlying TE voice are unknown, but pharyngoesophageal (PE) segment vibration has been shown to play a key role. The aim of this study was to systematically explore the mechanics of PE segment vibration during TE phonation. A 2D axisymmetric finite-element model with two domains representing the air and PE wall was developed. Comparison was made between models with different upper esophageal sphincter (UES) radius, and with different inflow pressures. The TE voice of total laryngectomy patients was assessed using Voice Symptoms Scale and VisiPitch recording. PE segment vibration and pressure gradient (ΔP) were measured using High Resolution Manometry with concurrent video-fluoroscopy. Simulation results revealed two different resonant frequencies, with maximal displacement at high frequencies increasing towards the UES. UES displacement increased with increased inflow pressure or UES diameter. Patient studies revealed that the location of maximal PE segment vibration ranged between the fourth and sixth cervical vertebrae. Average AP varied from 11-68 mmHg during phonation among subjects, and consistent with our simulation results, patients with higher AP reported a lower score on the voice symptom scale. The fundamental frequency determined from TE voice recordings corresponded with the computer simulations (209±67 Hz).

Voice Restoration After Total Laryngectomy.

The ability to speak and communicate vocally is a unique human characteristic that is often taken for granted but is fundamental to many activities of daily living. Loss of voice after total laryngectomy can lead to a serious decrease in quality of life and can precipitate significant frustration over the inability to communicate effectively. There are 3 main methods of voice restoration: esophageal speech, usage of the electrolarynx, and tracheal-esophageal puncture for tracheal-esophageal speech, which can be performed primarily or secondarily. Although all 3 methods have potential benefits, the gold standard is tracheal-esophageal speech.

Emotional and psychopathological disorders in laryngectomized oncological patients.

INTRODUCTION AND OBJECTIVES: It is unknown if patients who suffer from laryngeal cancer and undergo total laryngectomy experience as much emotional shock and psychological distress as patients with cancers in other locations do. The aim of the study was to identify the incidence of emotional and psychological disorders in laryngectomized patients and describe their symptomatological nuances. METHODS: A descriptive cross-sectional study of emotional and psychopathological response of 100 cancer patients undergoing total laryngectomy was performed. The patients were evaluated immediately after surgery (n=35), when initiating communicative rehabilitation (n=23) and 5 years after diagnosis (n=42), versus a control of 55 healthy subjects. Psychopathological assessment battery for anxiety, depression, intrusion, avoidance, arousal and posttraumatic stress disorder consisted of a specific interview, the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R). RESULTS: Laryngectomized patients had low incidence of emotional and psychological disorders such as anxiety (6.9%), depression (5.9%) and/or posttraumatic stress disorder (28.4%), but with sufficient intensity to constitute a psychopathological diagnosis. A significant level of distress was found in 57.4% of patients, with clear diffuse traumatic nature in 52.6% of them, which was more prevalent and intense in the rehabilitation group. CONCLUSIONS: Symptoms of anxiety, depression and posttraumatic stress disorder during different stages after total laryngectomy are not of sufficient intensity and quality to be diagnosable clinical entities; they can be considered an adaptive disorder. The symptoms are less than those of patients with cancer in other locations and appear mostly in the rehabilitation stage, where preventive performances and psychological support should be focused.

A Participatory Design Approach to Develop a Web-Based Self-Care Program Supporting Early Rehabilitation among Patients after Total Laryngectomy.

AIM: To develop a Web-based self-care program for patients after total laryngectomy according to a participatory design approach. METHODS: We conducted a needs assessment with laryngectomees (n = 9) and their partners (n = 3) by means of a focus group interview. In 4 focus group sessions, a requirement plan was formulated by a team of health care professionals (n = 10) and translated into a prototype. An e-health application was built including illustrated information on functional changes after total laryngectomy as well as video demonstrations of skills and exercises. Usability of the prototype was tested by end users (n = 4) and expert users (n = 10). Interviews were held to elicit the intention to use and the desired implementation strategy. RESULTS: Six main self-care topics were identified: (1) nutrition, (2) tracheostomy care, (3) voice prosthesis care, (4) speech rehabilitation, (5) smell rehabilitation, and (6) mobility of head, neck, and shoulder muscles. Expert users expressed concerns regarding tailored exercises, indicated a positive intent to implement the intervention in routine care, and expressed a need for guidance when implementing the intervention. End users and expert users appreciated the content completeness and multimedia-based information built into the application. CONCLUSION: The participatory design is a valuable approach to develop a self-care program to help meet users' needs.

[Effect of peer education on postoperative rehabilitation of patients with laryngeal cancer].

OBJECTIVE: To evaluate the effect of peer education on postoperative rehabilitation of patients with laryngeal cancer. METHODS: From January 2010 to December 2012, 240 cases of primary laryngeal cancer were treated with partial or total laryngectomy as well as tracheotomy in the Department of Head and Neck Surgery in Shandong Provincial Hospital. The patients were randomly divided into experimental group or control group by Stochastic tables law, 120 patients in control group accepted only conventional nursing, 120 patients in experimental group accepted both conventional nursing and peer education. The difference in the treatment nursing cooperation attitude, postoperative recovery, postoperative symptoms and the incidence of complications between two groups were evaluated by postoperative quality of life (UW-QOL), Eysenck personality questionnaire (EPQ) and coping style questionnaire (CSQ) score. The independent sample T-test and χ² test were used for statistical analysis. RESULTS: The patients of experimental group showed more positive attitude to treatment and care compared to the patients of control group (χ² = 10.7, P < 0.01). Experimental group had less time in postoperative wound healing time, gastric tube indwelling time and postoperative hospital stay than control group, with statistically significant differences (t = 6.89, t = 6.36, t = 6.42, respectively, P < 0.01); Incidence of postoperative discomfort symptoms in experimental group was less than that in control group (P < 0.05). Total score for quality of life (UW-QOL) in experimental group was higher than that in control group (t = 2.40, P < 0.05). The P and N scores of EPQ in experimental group were lower than those in control group (t = 2.28, t = 2.60, P < 0.05), while the E score of EPQ in experimental group was significantly higher than that in control group (t = 4.50, P < 0.01), with no significant difference in the L score of EPQ between two groups (P > 0.05). scores of factor to solve problem and help factor of CSQ in experimental group were higher than those in control group (t = 7.05, t = 7.73, P < 0.01), and the era factor score of experimental group was lower than that of control group (t = 2.05, P < 0.05). CONCLUSIONS: Peer education can help the patients with laryngectomy to maintain good psychological and mental status, to cooperate actively with treatment, to reduce symptoms and complications, and to shorten the length of hospital stay, improving their postoperative rehabilitation and quality of life.