Interdisciplinary interventions in the perioperative rehabilitation of total laryngectomy: an integrative review

Abstract

The aim of this study was to use the scientific literature to identify interdisciplinary interventions for rehabilitation during the perioperative period for cancer patients who underwent total laryngectomy. We systematically researched controlled descriptors: laryngectomy, patient care team/education, patient care team/manpower, patient care team/methods, patient care team/utilization and rehabilitation. We performed a qualitative narrative synthesis and identified 549 articles. Of these, 113 were duplicates, 398 were excluded during the analysis of the title and abstract, 1 was excluded for unfeasibility of access, and 4 were excluded after reading the article in full, resulting in 33 included articles. The articles addressed different types of interdisciplinary actions, such as vocal, olfactory, pulmonary and alimentary rehabilitation; comparisons of prosthetic devices; and descriptions of practices for total laryngectomized patient rehabilitation. Although the interventions found in the literature were effective in the rehabilitation of the total laryngectomized patient, their interdisciplinarity was not evidenced but was highlighted in these studies as a factor for improvement in terms of practical assistance and quality of life.

Total Laryngectomy—Still Cutting-Edge?

“…Olfaction can be re-learned with the “polite yawning” technique [ 105 ]. Yawning is carried out with closed lips creating a negative pressure in the mouth and throat, which can induce airflow through the nose.…”

“…In addition, there is a theoretical possibility of a laryngeal bypass system with tubes joining the tracheostomy and mouth outside the body, once more allowing breathing through the nose and even making it possible to go diving wearing specially designed masks [ 106 ]. The use of an HME as an artificial nose is recommended to protect the lungs and tracheal mucosa [ 1 , 105 ].…”

Clinical Implications of Larynge Cancer

“…3,5,6. The treatment for this type of cancer is defined according to the stage of the disease, and may be by radiotherapy and/ or chemotherapy, in association or not with surgical treatment. [7][8][9] Non-operative therapy is more likely to preserve the organ, and is sometimes used for this purpose, maintaining the structural and functional integrity of the larynx, in addition to reducing primary surgeries 2,3,7-9. Regardless of the type of treatment used, the quality of the patient's voice is affected. 2 Studies suggest that voice changes in patients with laryngeal cancer may appear up to ten years after the end of radiotherapy.…”

Women's perspective on life after total laryngectomy: a qualitative study

“…Since survival and complication rates improved over the last decades, scholarly attention has shifted towards providing patients with optimal supportive care (Rosa et al . , van der Molen et al . , Zenga et al .…”

“…Since survival and complication rates improved over the last decades, scholarly attention has shifted towards providing patients with optimal supportive care (Rosa et al 2018, van der Molen et al 2013, Zenga et al 2018). As we move in the direction of health models driven by patient-centred care, understanding the differential impacts of surgical procedures on subgroups of our patients is important to help improve our care models, patient education and support systems.…”