Abstract
ABSTRACT Purpose: the aim of this study was to analyze the relationship between patient-reported swallowing disorders and common mental disorders after total laryngectomy. Methods: fourteen patients of both genders and aged 66 ± 8.63 years were assessed after total laryngectomy. They were all asked about the perception of swallowing disorders and answered the Self-Reporting Questionnaire. Patients with swallowing complaints also answered the MD Anderson Dysphagia Inventory. The mean difference between groups was evaluated using the Mann-Whitney test, with a significance level of 5%. Results: the median of Self-Reporting Questionnaire total score was 3.00 [interquartile range: 0.00-5.00] and did not reflect the presence of common mental disorders. Five volunteers (35.7%) self-reported swallowing disorders and had a worse, although not significant (p = 0.15), performance on the Self-Reporting Questionnaire. The MD Anderson Dysphagia Inventory indicated a limitation in the quality of life, with a greater impact of swallowing disorders in the emotional domain [median = 53.30; interquartile range: 33.30-74.95]. Conclusion: common mental disorders are not related to patient-reported swallowing disorders following total laryngectomy. However, patients with swallowing complaints had a negative impact on their quality of life, especially in the emotional domain.
Highlights
Total laryngectomy (TL) corresponds to the entire removal of the larynx[1], and this implies in a definitive dissociation between the digestive and respiratory tracts, postoperative anatomical impairments can affect oropharyngeal swallowing because the elevation of the larynx is eliminated and the propulsion of the tongue base is decreased, leading to a rupture of the constricting musculature of the pharynx, an increase in pharyngeal transit time, the presence of pharyngeal residues and a decrease in esophageal peristalsis[2,3,4,5]
It is understood that dysphagia can restrict an individual’s relationship with their daily life, which allows us to assume that psychiatric disorders such as Common Mental Disorders (CMD) might emerge
The intensity and chronicity of CMD are related to developing diseases such as anxiety and depression[10,11,12,13,14], which is why CMD screening is important in patients with swallowing complaints, especially in cases associated with head and neck cancer in which there is a markedly greater risk of psychological distress and worse quality of life[15]
Summary
Total laryngectomy (TL) corresponds to the entire removal of the larynx[1], and this implies in a definitive dissociation between the digestive and respiratory tracts, postoperative anatomical impairments can affect oropharyngeal swallowing because the elevation of the larynx is eliminated and the propulsion of the tongue base is decreased, leading to a rupture of the constricting musculature of the pharynx, an increase in pharyngeal transit time, the presence of pharyngeal residues and a decrease in esophageal peristalsis[2,3,4,5]. TL dysphagia occurs in approximately 90% of the cases[5] and results in prolonged meals, dietary limitations, weight loss, malnutrition, decreased psychological well-being, suffering and impairment in social interactions[4,8]. Swallowing disorders following total laryngectomy can lead the patient to eating alone or losing the pleasure to eat, which can lead to impairment in social function and a decrease in quality of life[10,11,12]. The intensity and chronicity of CMD are related to developing diseases such as anxiety and depression[10,11,12,13,14], which is why CMD screening is important in patients with swallowing complaints, especially in cases associated with head and neck cancer in which there is a markedly greater risk of psychological distress and worse quality of life[15]
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