The pretreatment and treatment factors that influenced swallowing in this cohort should be considered when planning treatment, in discussing potential side effects with patients, and when developing and testing future treatment techniques.

There are limited data on swallowing outcomes after radiotherapy or chemoradiotherapy for head and neck cancer. Further work is needed to ascertain which aspects of swallowing should be measured, and then to use such measures in well-designed clinical trials and prospective cohort studies of this under-researched population.

No abstract

Although long-term patient-reported activity improves and swallowing-related QOL is high, up to 24% of patients may demonstrate a clinically significant deterioration in swallowing function at 5 years posttreatment. This divergence suggests a degree of adaptation that patients develop, which warrants further investigation. © 2015 Wiley Periodicals, Inc. Head Neck 38: E307-E315, 2016.

Over the past 20 years, use of tracheo-oesophageal puncture (TEP) speech after total laryngectomy has resulted in reported success rates of 90-93 per cent worldwide. Despite this, data collected from major acute hospitals in Victoria, Australia indicated that, of 38 patients who underwent total laryngectomy in 1997, only 10 (26 per cent) were using TEP speech as their primary mode of communication at 12 months post-operatively. This paper describes how a quantitative research methodology was used to investigate why so few patients in Victoria were successfully using TEP speech as their chosen mode of rehabilitation after total laryngectomy. Patients, speech pathologists and ENT surgeons were interviewed. Their thoughts and beliefs regarding speech rehabilitation were mapped, and themes were identified, coded and analysed. This paper describes and discusses the results of this research and its possible implications for future patient management, through establishing a model for 'ideal' speech rehabilitation.