Multidimensional evaluation of voice outcomes following total laryngectomy: a prospective multicenter cohort study

摘要

Purpose The purpose of this study is to assess the general course of acoustic, patient rated, and clinician-rated voice outcomes from pre- up to 12 months post total laryngectomy. Methods Patients admitted to a total laryngectomy in five participating hospitals in Australia and The Netherlands were included. Assessments took place at pre-, 3 months, 6 months, and 12 months post-surgery. Voice outcomes are evaluated with the Acoustic Voice Quality Index (AVQI), perceptual scales, and patient-reported outcome measures including VHI-10 and EQ-5D-5L. Statistical analyses include descriptive statistics,ttests (pre- to 6 months post-surgery), Linear Mixed Effect models. Results The study included 43 participants. A significant worsening ofAVQIis seen from pre- to post-surgery evaluated withttest (p < 0.001). The Linear Mixed Effect model confirmedTimeas a significant factor in predictingAVQIscore (p <= 0.001), as well asperceptual rated voice qualityby the clinician (p = 0.015) andpatient-reported perceptual rated voice quality(p = 0.002). No statistical significance was found inVHI-10scores over time. Conclusion Successful TE-speech was achieved in most participants, some had to rely on augmentative alternative communication methods. Patient-reported outcomes indicate acceptance of the condition and sufficient coping in the long term. However, acoustic rated voice quality is abnormal at all post-surgery time-points.AVQIproved to be a useful instrument to evaluate TE-speech. There is a need for validation and determination of cut-off values forVHI-10andAVQIfor use in TE-speech.