title: Voice, swallowing, and quality of life after total laryngectomy: results of the west of Scotland laryngectomy audit.
abstract: BACKGROUND
  The purpose of this study was to determine the effects of radiotherapy and surgical voice restoration on functional outcome after total laryngectomy.
  
  
  METHODS
  Questionnaire packs were posted to all 258 laryngectomy patients in the West of Scotland Managed Clinical Network. Packs contained the Voice Symptom Scale (VoiSS), MD Anderson Dysphagia Inventory (MDADI), and University of Washington Quality of Life Questionnaire (UW-QOL).
  
  
  RESULTS
  Significantly better VoiSS and MDADI scores were reported by patients undergoing laryngectomy alone in comparison with patients receiving adjuvant radiotherapy and patients undergoing salvage laryngectomy (p < .02). Patients using tracheoesophageal voice reported significantly better VoiSS scores than patients using other communication methods (p < .005).
  
  
  CONCLUSIONS
  Radiotherapy has a highly significant and detrimental effect on voice and swallowing outcome after total laryngectomy. Surgical voice restoration confers significant benefit in terms of self-reported voice outcome. These findings have implications for patients with advanced laryngeal cancer considering laryngectomy and organ preservation.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Glasgow Royal Infirmary, United Kingdom. stuart@glasgow.org
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Robertson
authors.forename: Justin C L
authors.initials: JC
authors.lastname: Yeo
authors.forename: Catherine
authors.initials: C
authors.lastname: Dunnet
authors.forename: David
authors.initials: D
authors.lastname: Young
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mackenzie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition / Q000528:radiation effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy; D007830:Larynx / Q000528:radiation effects* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012606:Scotland / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014831:Voice / Q000528:radiation effects*; D055815:Young Adult