Evaluation of Quality of Life After Total Laryngectomy

Abstract Purpose Total laryngectomy is a surgical approach performed due to advanced-stage cancers and significantly affects the patient's post-operative quality of life. In this study, it was aimed to evaluate the extent to which the physical, psychological, and functional characteristics of patients were affected after this surgery, which significantly alters their quality of life, and the effectiveness of the measures we could take for these issues. Method Between 2018 and 2023, 44 total laryngectomy patients operated on in our clinic were included in the study, and the European Organization for Research and Treatment of Cancer Quality of Life Scale EORTC QLQ-Head & Neck35 (EORTC QLQ-H&N35, briefly EORTC-35) questionnaire was administered, determining the physical, psychological, and functional changes that occurred compared to before the surgery. Especially in patients with additional comorbidities, those undergoing radiotherapy-chemotherapy, and those using voice prostheses after the operation, it was also investigated whether there was a difference compared to those who only underwent total laryngectomy. Results The evaluation of patients' functional loss, social problems, and symptom scores contributes to determining the quality of life post-surgery and helps in preserving the patients' living standards in the best possible way. In this context, the EORTC QLQ-H&N35 Quality of Life Scale is a widely used quality of life scale for cancer patients worldwide. Pain, difficulty swallowing, speech, and social communication, along with the degrees of physical complaints that develop, are also evaluated. In our study, we aimed to determine the quality of life levels of the patients using this scale. In our patients, we found that the use of voice prostheses made significant contributions to preserving speech functions. Additionally, we observed more pronounced functional losses, particularly in swallowing, in patients undergoing chemoradiotherapy. The use of a voice prosthesis by the patient significantly contributes to their quality of life, while additional treatments such as radiotherapy and chemotherapy lead to more frequent adverse outcomes in patients. By evaluating the patients' complaints, it is possible to positively contribute to their quality of life with appropriate treatment approaches, rehabilitation methods, and psychological support programs. Discussion Total laryngectomy is an aggressive surgical approach performed to sever the connection between the upper and lower airways due to tumor formations in the larynx region that involve significant structures. Patients not only face a life-threatening illness but also have to cope with the functional, psychological, and sensory losses caused by this important surgical procedure required for treatment. Especially to assess the effects of certain losses, particularly speech loss, various questionnaires have been developed. Among these questionnaires, the most commonly used ones are EORTC-30 and EORTC-35. The European Organization for Research and Treatment of Cancer has designed the EORTC-35 quality of life scale questionnaire for head and neck cancer patients. This questionnaire was developed as a modification of the EORTC-30 and specifically created for patients with head and neck cancer. In the EORTC-35 questionnaire, functional characteristics such as eating and swallowing, speech, sensory characteristics such as pain and loss of smell, and psychosocial criteria such as social communication are evaluated with 18 questions. In our study, by using this questionnaire, it is aimed to identify the factors that seriously affect the quality of life of patients after surgery and to provide measures or appropriate rehabilitation, thereby improving both the patient's own living standards and their relationship with their surroundings.