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Quality‐of‐life and functional outcomes following pharyngolaryngectomy: a systematic review of literature
Author(s) -
Mahalingam S.,
Srinivasan R.,
Spielmann P.
Publication year - 2016
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.12466
Subject(s) - medicine , laryngectomy , quality of life (healthcare) , dysphagia , medline , systematic review , inclusion and exclusion criteria , swallowing , hypopharyngeal cancer , intensive care medicine , surgery , cancer , larynx , pathology , alternative medicine , nursing , political science , law
Background The long‐term prognosis of hypopharyngeal cancer is poor. Surgery necessitates pharyngolaryngectomy with flap reconstruction. For such patients, it is important that functional outcomes are preserved to maintain a respectable quality of life. Objective of review To identify the functional outcomes following pharyngolaryngectomy with respect to quality of life, speech and swallow through a systematic review of literature. Search strategy Searches of EBM databases and literature databases using key words: pharyngolaryngectomy, laryngopharyngectomy, swallow, dysphagia, speech and dysphonia from 1970 to August 2014. Articles were screened for relevance using pre‐determined inclusion and exclusion criteria. Evaluation method Articles reviewed by authors and data compiled in tables for analysis. Results No previous systematic reviews assessing functional outcomes were identified. Seventeen studies reported speech outcomes (576 patients) and fifteen reported swallow outcomes (1076 patients). The data suggests that patients who underwent trachea‐oesophageal puncture developed more favourable speech outcomes than those rehabilitated using other measures. Overall stricture incidence was 11.4% and 6.5% of patients required long‐term enteral nutrition. Four studies used validated speech measures, and three used validated swallow measures. They suggest an overall level of perceived impairment in quality of life. Speech and swallow outcomes were significantly poorer than patients who underwent total laryngectomy. Conclusions Overall, there is an impairment in speech and swallow outcomes following pharyngolaryngectomy; however, the exact extent is unclear. There is a need for a general consensus on assessment measures and prospective multicentre studies to be conducted. This study compiles the available data to improve caregiver and patient awareness of functional outcomes.