Laryngectomy: a quality of life assessment.

Cosmetic disfigurement and loss of voice following a total laryngectomy can cause major psychosocial problems. Fifty patients who had undergone a total laryngectomy and completed more than six months following surgery, were randomly selected during a routine follow-up, and asked to answer a questionnaire, to asses their degree of disability and extent of rehabilitation. The questionnaire have five main components viz. general information, functional evaluation, vocal rehabilitation, social assessment and economic sequelae. Results revealed that these patients suffered from a significant decrease in social acceptance (70%), social activity (82%), sexual activity (62%), ability to communicate vocally (58%), and severe financial repercussions (78%). A large number of patients (40%) were dissatisfied with the present level of rehabilitation offered. Inspite of these problems the majority (80%) were willing to accept a total laryngectomy as treatment of their cancer. This emphasizes the need for greater interaction between the treating surgeon, speech therapist, occupational therapist, and psychotherapist to rehabilitate these patients adequately.