Psychosocial Determinants of Successful Voice Rehabilitation After Laryngectomy

Abstract

This study gives an overview of publications on factors that are associated with the outcome of voice rehabilitation after laryngectomy. A systematic literature review was conducted. Fifty-six manuscripts were analyzed regarding the parameters investigated, the number of participants included, the study designs used, the assessment instruments, and the results. A broad range of factors were considered to contribute to successful voice rehabilitation, whereby psychosocial attributes related to success are mentioned as often as medical and treatment-related characteristics. The results of the studies are mostly inconsistent. It can be concluded, however, that active communication behavior, employment status, type of alaryngeal speech and the general physical condition are associated with rehabilitation outcomes, whereas alcohol consumption is not. More comprehensive prospective studies are needed which analyze the impact of psychosocial factors with validated and standardized instruments. A large sample size would be necessary to calculate all possibly relevant factors and their interaction. Clinicians should be careful about considering their patients to be "unmotivated" if the rehabilitation fails; instead, they should encourage them to communicate actively and take part in social activities.

Effects of Neck Dissection and Radiotherapy on Short-Term Speech Success in Voice Prosthesis Restoration Patients

“…10,12,13 The overall failure rate was 16% in our study. The common causes of voice restoration failure include dysfunction/malfunction of the prosthesis itself and reduced flexibility or patency of the pharyngoesophageal segment and other issues, such as occlusion of the tracheostoma.…”

Possible factors of success in teaching esophageal speech

“…Bohme [20] states that the success of training depends on general factors, such as psychological ones, motivation being one of the most important [21]. Đukić et al [3] emphasize the importance of assessing the level of motivation during the first contact with the patient in order to give support adequate to that level.…”

Speech rehabilitation during the first year after total laryngectomy

“…1 In 5% to 15% of the cases, patients do not acquire any voice. 2,3 Frequently, particularly in older publications, acquiring an esophageal voice, in contrast to using a device, is considered a success. [4][5][6] However, for some patients, it is vital to acquire a voice quickly; therefore, an electronic device is an acceptable alternative if it helps in speeding up the rehabilitation process.…”