Arenaz Búa Beatriz, Pendleton Hillevi, Westin Ulla, Rydell Roland
a Division of Logopedics, Phoniatrics and Audiology Department of Clinical Sciences , Lund University, Skane University Hospital , Malmö , Sweden.
b Division of Ear, Nose and Throat Diseases, Head and Neck Surgery, Department of Clinical Sciences , Lund University, Skane University Hospital , Malmö , Sweden.
Acta Otolaryngol. 2018 Feb;138(2):170-174. doi: 10.1080/00016489.2017.1384056. Epub 2017 Oct 5.
Voice and swallowing problems are often seen in patients with advanced larynx cancer, after total laryngectomy (TL) and chemo/radiotherapy. The aim of this study was to determine the occurrence of voice and swallowing problems in patients who have been laryngectomised and investigate if these symptoms were related to age, time after TL, radiotherapy and TNM-classification. In addition, we studied how often the patients changed their voice prostheses and the need of therapeutic interventions after TL.
Forty-five patients were included in the study and completed the Swedish version of the Sydney Swallow Questionnaire and the Voice Handicap Index-T.
Swallowing problems were reported by 89% of the patients and moderate-to-severe voice handicap was reported by 66%. Most of the subjects who had dysphagia also presented voice problems (r = 0.67 p ≤ .01). Additional therapeutic interventions to manage problems with voice and/or swallowing after TL were required in 62% of the patients.
Swallowing and voice problems after TL are common. Thus, the preoperative information and assessment of these functions, as well as the treatment and the post-operative rehabilitation should be evaluated and optimised to provide better functional results after treatment of advanced larynx cancer.
晚期喉癌患者在全喉切除术（TL）及放化疗后常出现声音和吞咽问题。本研究旨在确定喉切除术后患者声音和吞咽问题的发生率，并调查这些症状是否与年龄、TL术后时间、放疗及TNM分期有关。此外，我们还研究了患者更换发音假体的频率以及TL术后治疗干预的需求。
45例患者纳入本研究，完成了瑞典语版的悉尼吞咽问卷和嗓音障碍指数-T。
89%的患者报告有吞咽问题，66%的患者报告有中度至重度嗓音障碍。大多数吞咽困难的受试者也存在声音问题（r = 0.67，p≤0.01）。62%的患者在TL术后需要额外的治疗干预来处理声音和/或吞咽问题。
TL术后吞咽和声音问题很常见。因此，应评估和优化术前这些功能的信息及评估，以及治疗和术后康复，以在晚期喉癌治疗后提供更好的功能结果。
