Rehabilitation after supracricoid partial laryngectomy: cohort study

Abstract

Objectives: To evaluate vocal, swallowing and respiratory rehabilitation of patients undergoing supracricoid laryngectomy; evaluate the impact of voice changes and global quality of life. Methods: It is a prospective cohort study where voice, swallowing and respiratory rehabilitation where evaluated. Quality of life was assessed using EORTC QLQ-C30 and H&N35 questionnaires. Results: 31 patients were included in the study. 70.4% of patients were T3. In swallowing assessment, two patients (6.4%) were considered non-rehabilitated. Ten patients (32.2%) were considered partially rehabilitated and 19 (61.3%) fully rehabilitated. Sensitivity was abnormal at 74.2%. Penetration occurred in 58.1% of patients with 29% experiencing aspiration. In voice assessment, 19 (61.3%) patients were considered rehabilitated. 77.41% had a calculated voice handicap index considered abnormal. When assessing breathing, eight patients (25.8%) were considered non-rehabilitated. Disease-free survival was 87.1% in follow-up of 5.77 years. When subjected to specific exams and evaluations, only 38.7% were completely rehabilitated. When comparing results of EORTC-C30 and H&N35 questionnaires with the reference values, global score and domain scores are better on the patients of the study, as well as some of the symptoms. Conclusion: Partial supracricoid laryngectomy remains an option in patients with laryngeal tumors, especially in the most advanced ones, with a survival rate around 90%. Quality of life is impacted after surgery, but with few symptoms. Level of evidence: Level 3.1

Keywords

• Laryngeal neoplasms
• Laryngectomy
• Rehabilitation of speech and language disorders
• Rehabilitation
• Quality of life