QOL Evaluation in Patients with Tracheoesophageal Speech and Esophageal Speech

Abstract

Esophageal speech, electric larynx and tracheoesophageal speech have been used for substitute speech in patients after laryngectomy. However, there have been no studies comparing them in terms of QOL. Twenty-four cases of laryngeal carcinoma or hypopharyngeal carcinoma treated with a total laryngectomy with or without reconstruction at the University of Tsukuba Hospital from 1998 to 2012 were clinically analyzed. Ten patients had tracheoesophageal speech and fourteen patients had esophageal speech. The patients with tracheoesophageal speech consisted of 9 males and 1 female ranging in age from 49 to 83 years old (mean age 61.1). On the other hand, the patients with esophageal speech consisted of 14 males ranging in age from 65 to 80 years old (mean age 70.0). All patients in the two groups answered two kinds of questionnaire, namely, the Voice Handicap Index (VHI) revised edition and the Voice-Related Quality of Life (V-RQOL) Japanese edition. The conversation acquisition rates of the patients with tracheoesophageal speech and the patients with esophageal speech were 90.9 and 42.8%, respectively, and the acquisition rate was significantly higher in the patients with tracheoesophageal speech. The total VHI scores of the patients with tracheoesophageal speech and the patients with esophageal speech (average±standard deviation) were 60.5±17.2 and 78.9±17.8 points, respectively, and the total V-RQOL scores of the patients with tracheoesophageal speech and the patients with esophageal speech (average±standard deviation) were 54.1±15.9 and 32.7±19.1 points respectively. The results strongly suggested that a high QOL was observed with both evaluations in patients with tracheoesophageal speech. Thus, tracheoesophageal speech might be effective for vocalization in alaryngeal patients from the point of view of their QOL.