RESUMO
BACKGROUND: Health-related quality of life (HRQL) and voice handicap index (VHI) of laryngectomies seem to be relevant regarding voice rehabilitation. The aim of this study is to assess the impact on HRQL and VHI of laryngectomies, following voice rehabilitation. MATERIALS AND METHODS: A retrospective study done at the Ear, Nose, and Throat Department of the Emergency County Hospital. Sixty-five laryngectomees were included in this study, of which 62 of them underwent voice rehabilitation. Voice handicap and QOL were assessed using the QOL questionnaires developed by the European Organisation for Research and Treatment of Cancer (EORTC); variables used were functional scales (physical, role, cognitive, emotional, and social), symptom scales (fatigue, pain, and nausea and vomiting), global QOL scale (pain, swallowing, senses, speech, social eating, social contact, and sexuality), and the functional, physical, and emotional aspects of the voice handicap (one-way ANOVA test). RESULTS: The mean age of the patients was 59.22 (standard deviation = 9.00) years. A total of 26 (40%) patients had moderate VHI (between 31 and 60) and 39 (60%) patients had severe VHI (higher than 61). Results of the HRQL questionnaires showed that patients who underwent speech therapy obtained better scores in most scales (P = 0.000). Patients with esophageal voice had a high score for functional scales compared with or without other voice rehabilitation methods (P = 0.07), and the VHI score for transesophageal prosthesis was improved after an adjustment period. The global health status and VHI scores showed a statistically significant correlation between speaker groups. CONCLUSION: The EORTC and the VHI questionnaires offer more information regarding life after laryngectomy.
RESUMO
BACKGROUND: The goal of the study is to test medialization of the neocord after oncological surgery for glottic cancer, using autologous tragal cartilage and perichondrium by the direct approach. MATERIALS AND METHODS: Sixteen patients underwent comprehensive assessment including auditory perceptual assessment, videostrobolaryngoscopy, and acoustic voice analysis. The cartilage graft was inserted into a pocket created in the tyroarytenoid - lateral cricoarytenoid muscle complex or the excavated musculomembranous part of the neocord, and fixed by placing the perichondrium by the direct approach. The patients were evaluated preoperatively, and at 14 days, 60 days, and 6 months later. RESULTS: Improvement of voice and breathiness was correlated with the increase of closed quotient and harmonic-to-noise ratio; the acoustic voice parameters studied showed significant differences between preoperative and postoperative voices, and these objective measurements of voice changes provided accurate and documentary evidence of the results of surgical treatment. CONCLUSION: This method may be considered a safe and efficient phonosurgical procedure for voice restoration.
