Tracheoesophageal puncture (TEP) with a voice prosthesis has been the preferred treatment for speech rehabilitation of total laryngectomies at the Dr. Peset Hospital since 1984. This study reviews 350 consecutive patients over a 15-year period. There were 334 patients with primary and 16 with secondary TEP. Long-term tracheoesophageal speech was achieved in approximately 70% of our patients. Problems related to or affecting TEP for voice restoration were studied. The different types of problems identified occurred in proportions ranging from 0.6% to 18%. Most of them were easily managed, but problems such as salivary leakage and dislodging of the prosthesis led to tracheoesophageal tract closure in 30% of the patients.

OBJECTIVE:To assess the psychosocial adjustment in 62 patients surgically treated for cancer of the head and neck. STUDY DESIGN AND SETTING: Forty-one patients were grouped as having had radical surgery (total laryngectomy) and 21 as having had functional surgery (horizontal supraglottic laryngectomy or partial vertical surgery). The Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) was used for the evaluation. RESULTS: No significant differences were found between groups when global adjustment or domain adjustment was compared. Patients did not consider the permanent stoma and voice loss to be the most important determinant of quality of life. Work and family relationship were the domains with poorest adjustment. CONCLUSION: Social and medical support are important factors in improving patients' self-confidence and satisfaction, playing an important role in recovering useful phonation, psychological adjustment, and global quality of life. SIGNIFICANCE: Information collected in this way may facilitate improved rehabilitation and thus better quality of life. (Otolaryngol Head Neck Surg 2003;129:92-7.) Little is known about the adaptation of patients after treatment and how the presence of sequelae impacts the different aspects of a patient's personal and family life. Although the concept of quality of life is easily understood, its definition and evaluation tools are not familiar outside the behavioral science area. Most studies consider survival and disease control as the end points of their clinical trials, without analyzing the patient's opinion regarding morbidity and whether posttreatment expectations were achieved.Evaluation of quality of life in cancer of the head and neck is especially important because the treatment sequelae impact directly on basic daily functions like breathing, swallowing, speaking, and even on external appearance. Quality of life studies can give us a better idea and understanding of what patients consider to be their problems and priorities after treatment.The purpose of this study was to evaluate the impact of surgical sequelae treatment of cancer of the larynx on the psychosocial adjustment of patients and identify those factors the patients consider most important in the adjustment process. PATIENTS AND METHODSPatients were treated for laryngeal cancer at the Department of Otorhinolaryngology of the Dr Peset University Hospital, Valencia, Spain. Data were collected through mail questionnaires answered by 62 patients who had undergone surgery for laryngeal or hypopharyngeal cancer All patients were followed for more than 36 months. Appropriate consent was obtained from patients who were informed of the aim of the study and assured of the confidentiality of data and voluntary character of the study. Instructions were given to answer questions with reference to the 4 weeks before completion of the questionnaire.The mean age was 63.8 years (range, 41 to 85); 99% (61/62) were male; 87% were married, 2% were divorced, 5% were single, and 6% were widowed. Seventy-one pe...

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OBJECTIVE: To assess the psychosocial adjustment in 62 patients surgically treated for cancer of the head and neck. STUDY DESIGN AND SETTING: Forty-one patients were grouped as having had radical surgery (total laryngectomy) and 21 as having had functional surgery (horizontal supraglottic laryngectomy or partial vertical surgery). The Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) was used for the evaluation. RESULTS: No significant differences were found between groups when global adjustment or domain adjustment was compared. Patients did not consider the permanent stoma and voice loss to be the most important determinant of quality of life. Work and family relationship were the domains with poorest adjustment. CONCLUSION: Social and medical support are important factors in improving patients' self-confidence and satisfaction, playing an important role in recovering useful phonation, psychological adjustment, and global quality of life. SIGNIFICANCE: Information collected in this way may facilitate improved rehabilitation and thus better quality of life.