Patients With Voice Prosthesis Rehabilitation During the COVID‐19 Pandemic: Analyzing the Effectiveness of Remote Triage and Management

Abstract

Objective To describe a remote approach used with patients with voice prosthesis after laryngectomy during the COVID-19 pandemic and the resulting clinical outcomes in terms of voice prosthesis complications management, oncological monitoring, and psychophysical well-being. Study Design Prospective cohort study. Setting Otolaryngology Clinic of the University Polyclinic A. Gemelli, IRCCS Foundation. Subjects and Methods All patients with voice prosthesis who underwent laryngectomy followed by our institute were offered enrollment. Patients who agreed to participate were interviewed to inquire about the nature of the need and to plan a video call with the appropriate clinician. Before and 1 week after the clinician’s call, patients were tested with the Hospital Anxiety and Depression Scale. Degrees of satisfaction were investigated with a visual analog scale. A comparison between those who accepted and refused telematic support was carried out to identify factors that influence patient interest in teleservice. Results Video call service allowed us to reach 37 (50.68%) of 73 patients. In 23 (62.16%) of 37 cases, the video call was sufficient to manage the problem. In the remaining 14 cases (37.83%), an outpatient visit was necessary. Participants who refused telematic support had a significantly shorter time interval from the last ear, nose, and throat visit than patients who accepted (57.95 vs 96.14 days, P = .03). Video-called patients showed significantly decreased levels of anxiety and depression (mean Hospital Anxiety and Depression Scale total score pre– vs post–video call: 13.97 vs. 10.23, P < .0001) and reported high levels of satisfaction about the service. Conclusion Remote approach may be a viable support in the management of patients with voice prosthesis rehabilitation.

Self-care and clinical management of persons with laryngectomy during COVID-19 pandemic: a narrative review

“…• Telemedicine facilitates access to care [ 21 ]; can be used for management of patients as well as surveillance [ 20 ] especially those using TE speech [ 11 , 13 ]…”

“…• Minor issues can be resolved via video calls and reserve the hospital visit to those who need immediate medical attention [ 11 ]…”

“…Laryngectomy bib or high neck clothing may serve the purpose [ 9 ], but the use of a surgical mask to cover the stoma is highly recommended [ 5 , 10 ]. Furthermore, it is advised to tie it in the following manner- upper strings tied around the neck and using an extender string to tie the lower strings at the back [ 11 , 12 ]. Usage of N95 mask is not recommended as it does not provide an adequate seal around the stoma [ 5 ]…”

“…Therefore, the ideal recommendation is that persons with laryngectomy use facial masks along with filtering devices coupled with a surgical mask for their stomas [ 11 – 13 , 15 ]. Those unable to wear an HME due to cost or incompatibility are advised to ensure covering of their stoma with either surgical mask, laryngeal bib, or clothing.…”

COVID-19: Impact on the Musician and Returning to Singing; A Literature Review

“…If the patient must come to the office, proper precautions must be taken and may include having the patient tested for COVID-19. If a patient is positive for COVID-19 but has a life-threatening complication from a tracheoesophageal prosthetic device, full precautions must be followed, including having the head and neck surgeon do both the medical assessment and the procedure in order to reduce the number of people who come in contact with the patient 55 . Another study examined similar protocols in patients with voice prosthesis.…”