Primary mode of communication for people with total laryngectomy in the UK: a cross-sectional survey.

OBJECTIVE: This study aimed to report on the UK rate of surgical voice restoration usage and investigate the factors that influence its uptake. METHOD: A national multicentre audit of people with total laryngectomy was completed over a six-month period (March to September 2020) in response to the coronavirus disease 2019 pandemic. This study is a secondary analysis of the data collected, focusing on the primary communication methods used by people with total laryngectomy. RESULTS: Data on surgical voice restoration were available for 1196 people with total laryngectomy; a total of 852 people with total laryngectomy (71 per cent) used surgical voice restoration. Another type of communication method was used by 344 people. The factors associated with surgical voice restoration in the multiple regression analysis were sex (p = 0.003), employment (employed vs not employed, p < 0.001) and time post-laryngectomy (p < 0.001). CONCLUSION: This study provides an important benchmark for the current status of surgical voice restoration usage across the UK. It found that 71 per cent of people with total laryngectomy used surgical voice restoration as their primary communication method.

Adherence to swallowing recommendations during (chemo)radiotherapy in head and neck cancer survivors: a scoping review.

PURPOSE OF REVIEW: There is a paucity of knowledge regarding patient adherence to dysphagia recommendations. It is recognized that unique barriers and facilitators contribute to poor treatment adherence in head and neck cancer (HNC) survivors. This review aims to identify the key themes and knowledge gaps regarding adherence to swallowing recommendations in HNC survivors during (chemo)radiotherapy (C)RT. RECENT FINDINGS: Seven studies were identified. Six facilitators to adherence were extracted, namely pain relief, behavioural intervention, attendance at multidisciplinary clinic, individualised swallowing therapy, absence of prophylactic percutaneous endoscopic gastronomy (PEG) and positive social control from a spouse. Barriers to adherence included pain, depression and presence of prophylactic PEG. Adherence to swallowing recommendations positively impacted swallowing outcomes in one study. SUMMARY: Little is known about adherence to swallowing recommendations during (C)RT in HNC survivors. Capturing adherence is challenging. Several knowledge gaps were identified. Further research is needed to better understand the barriers and facilitators from the survivors' perspective. This will inform development of best practice regarding how swallowing recommendations are provided to promote adherence and improve outcomes.

Investigating the impact of unfamiliar speaker accent on auditory comprehension in adults with aphasia.

BACKGROUND: In an increasingly multicultural society, all individuals are likely to come into contact with speakers with unfamiliar accents. Recent figures suggest that such accent variation may be particularly apparent within the healthcare workforce. Research on accent variation has demonstrated that an unfamiliar speaker accent can affect listener comprehension, but the impact of speaker accent on the comprehension skills of listeners with neurological impairment has not been widely explored. AIMS: To investigate the effect of an unfamiliar accent on the sentence comprehension of individuals with aphasia following stroke. METHODS & PROCEDURES: The impact of two different accents (south-east England and Nigerian) on accuracy and response time for 16 individuals with aphasia and 16 healthy control subjects was measured. Participants were presented with a computerized sentence-to-picture matching task and their accuracy and response times were recorded. OUTCOMES & RESULTS: Results showed that individuals with aphasia made significantly more errors in comprehension of sentences spoken in an unfamiliar accent than in a familiar accent, a finding that was not demonstrated by the control group when outliers were excluded. Individuals with aphasia were slower overall; however, response times did not show significant effects of speaker accent for either group. CONCLUSIONS & IMPLICATIONS: The impact of speaker accent should be considered in the rehabilitation of individuals with aphasia following stroke. Clinical implications include the possibility of underestimating an individual's language abilities on assessment, and the potential errors in comprehension that may occur.