Long-term quality of life after total laryngectomy.
BACKGROUND
There is a perception that a total laryngectomy has a devastating effect on patients and their families, but only a few studies have addressed long-term quality of life (QOL) after laryngectomy.


METHODS
A cross-sectional study of 49 patients more than 2 years since laryngectomy was performed with a general health status instrument (Short Form-12, version 2 [SF-12 v2.]) and a disease-specific QOL instrument (University of Washington Quality of Life questionnaire, version 4 [UW-QOL v4.]) in a national meeting of laryngectomy survivors.


RESULTS
As measured by the UW-QOL, patients identified speech, appearance, and activity as the most important problems after total laryngectomy, but surprisingly, no correlation was seen between speech and overall QOL. Age was a predictor of appearance and anxiety, women were more likely to report difficulties swallowing, irradiated patients reported more difficulties with speech and anxiety, and patients who received chemotherapy were more likely to report difficulties with mood. The SF-12 captured no differences between normal subjects and laryngectomees in the physical summary domain (p = .21); however, laryngectomees scored better in the mental domain (p = .004). Laryngectomees had lower scores in physical function (p = .005) and role physical (p = .036).


CONCLUSIONS
Long-term QOL is not decreased after total laryngectomy when it is measured with general health instruments and compared with the normal population, but impairment in physical scales is found when disease-specific questionnaires or subscale scores are included. Age, sex, radiation therapy, and chemotherapy are independent predictors of UW-QOL subscales. Voice handicap is identified as a problem but is not predictive of overall QOL. A strong relationship exists between UW-QOL and SF-12.
Vilaseca
Isabel
I
Department of Otolaryngology, Hospital Clínic i Universitari, Barcelona, Spain.
Chen
Amy Y
AY
Backscheider
Andrea G
AG
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000209:etiology; D004954:Esthetics; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000628:therapy*; D006305:Health Status Indicators; D006801:Humans; D007825:Laryngectomy / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology; D010147:Pain Measurement; D011788:Quality of Life; D012737:Sex Factors; D013064:Speech Disorders / Q000209:etiology; D011795:Surveys and Questionnaires; D013651:Taste Disorders / Q000209:etiology