Tracheoesophageal Prosthesis Use Is Associated With Improved Overall Quality of Life in Veterans With Laryngeal Cancer

Ramya S. Patel, Tiffany Mohr, Christine Hartman, Carol Stach, Andrew G. Sikora, Jose P. Zevallos, Vlad C. Sandulache

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objectives: Veterans have an increased risk of laryngeal cancer, yet their oncologic and functional outcomes remain understudied. We sought to determine the longitudinal impact of tracheoesophageal puncture and voice prosthesis on quality-of-life measures in veterans following total laryngectomy (TL). Methods: We performed a cross-sectional analysis of TL patients (n = 68) treated at the Michael E. DeBakey Veterans Affairs Medical Center using the Voice Handicap Index (VHI), MD Anderson Dysphagia Index (MDADI), and University of Washington Quality of Life Index (UW-QOL). Results: Using tracheoesophageal (TE) speech was associated with significantly better VHI, MDADI, and UW-QOL scores compared to other forms of communication. The association between TE speech use on VHI, MDADI, and UQ-QOL persisted even when the analysis was limited to patients with >5-year follow-up and was maintained on multivariate analysis that accounted for a history of radiation and laryngectomy for recurrent laryngeal cancer. Conclusions: Using tracheoesophageal speech after total laryngectomy is associated with durable improvements in quality of life and functional outcomes in veterans. Tracheoesophageal voice restoration should be attempted whenever technically feasible in patients that meet the complex psychosocial and physical requirements to appropriately utilize TE speech.

Original languageEnglish
Pages (from-to)421-428
Number of pages8
JournalAnnals of Otology, Rhinology and Laryngology
Volume127
Issue number7
DOIs
StatePublished - Jul 1 2018

Keywords

  • total laryngectomy
  • tracheoesophageal prosthesis
  • veterans

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