Health-Related Quality of Life, Dysphagia, Voice Problems, Depression, and Anxiety After Total Laryngectomy

Nille B Wulff; Susanne O Dalton; Irene Wessel; Beatriz Arenaz Búa; Helena Löfhede; Eva Hammerlid; Trille K Kjaer; Christian Godballe; Thomas Kjaergaard; Preben Homøe

doi:10.1002/lary.29857

Health-Related Quality of Life, Dysphagia, Voice Problems, Depression, and Anxiety After Total Laryngectomy

Laryngoscope. 2022 May;132(5):980-988. doi: 10.1002/lary.29857. Epub 2021 Sep 7.

Authors

Nille B Wulff¹, Susanne O Dalton^{2

3

4}, Irene Wessel^{4

5}, Beatriz Arenaz Búa⁶, Helena Löfhede⁷, Eva Hammerlid^{7

8}, Trille K Kjaer², Christian Godballe⁹, Thomas Kjaergaard¹⁰, Preben Homøe^{1

4}

Affiliations

¹ Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark.
² Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.
³ Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Naestved, Denmark.
⁴ Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁵ Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
⁶ Division of Ear, Nose and Throat Diseases, Head and Neck Surgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
⁷ Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁸ Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁹ Research Unit for ORL-Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
¹⁰ Department of Otorhinolaryngology-Head and Neck Surgery, Aarhus University, Aarhus, Denmark.

PMID: 34490903
DOI: 10.1002/lary.29857

Abstract

Objectives/hypothesis: The aims were to determine health-related quality of life (HRQoL), including voice problems, dysphagia, depression, and anxiety after total laryngectomy (TL), and investigate the associations between HRQoL and the late effects.

Study design: Cross-sectional study.

Methods: 172 participants having received a TL 1.6 to 18.1 years ago for laryngeal/hypopharyngeal cancer filled in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, Core and Head and Neck module (EORTC QLQ-C30, EORTC QLQ-H&N35), Voice-Related Quality of Life questionnaire (V-RQOL), M.D. Anderson Dysphagia Inventory (MDADI), and Hospital Anxiety and Depression Scale (HADS) questionnaires.

Results: Participants scored worse than normative reference populations on all scales/items of the EORTC questionnaires, except one, and almost half of the scales/items showed a clinically relevant difference. Moderate/severe dysphagia was present in 46%, moderate/severe voice problems in 57%, depression in 16%, and anxiety in 20%. Decreasing age, increasing numbers of comorbidities, increasing voice problems, increasing dysphagia, and increasing depression symptoms, were associated with a lowered EORTC QLQ-C30 summary score.

Conclusion: A substantial proportion of participants experienced clinically significant late effects and increasing levels of these were associated with a lowered HRQoL.

Level of evidence: 3 Laryngoscope, 132:980-988, 2022.

Keywords: Total laryngectomy; depression; dysphagia; health-related quality of life; voice problems.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety / epidemiology
Anxiety / etiology
Cross-Sectional Studies
Deglutition Disorders* / epidemiology
Deglutition Disorders* / etiology
Depression / epidemiology
Depression / etiology
Humans
Laryngeal Neoplasms* / surgery
Laryngectomy / adverse effects
Quality of Life
Surveys and Questionnaires
Voice Disorders*