Scientific Session: Laryngology and Pharyngo-Esophagology II
ABEA056 - Self-reported Measures Of Voice And Swallowing, Functional Oral Intake And Quality Of Life In Head And Neck Cancer Survivors Before And After Functional Laryngectomy For Intractable Aspiration
Sunday, May 1, 2022
10:42 AM – 10:48 AM CT
Location: Landmark D
Lisa Evangelista, Nogah Nativ-Zeltzer, Arnaud Bewley, Andrew Birkeland, Marianne Abouyared, Tess Andrews, Maggie Kuhn, D. Gregory Farwell, Peter Belafsky
Director of Speech Pathology University of California, Davis Medical Center Sacramento, California
Objective: The ability of functional laryngectomy (FL) to improve self-perceptions of voice and swallowing and quality of life (QOL) in head and neck cancer (HNCA) survivors with intractable aspiration is uncertain.
Method: HNCA survivors undergoing FL were prospectively evaluated. Self-reported measures of voice (VHI10) and swallowing (EAT10), functional oral intake scale (FOIS) and quality of life (FACT_HN) were assessed before and 1, 3 and 6 months after FL.
Results: 13 men with a mean age of 71 (±7) were enrolled. All patients underwent chemoradiation and the mean time from completion of oncologic treatment to FL was 11.5 (±4.5) years. Two patients (15%) died from aspiration pneumonia after enrollment prior to FL. EAT10 improved from 35.62 (+/- 2.0) to 20.50 (+/- 4.43) at 1, 10.62 (+/- 2.48) at 3 and 6.62 (+/- 1.53) at 6 months (p=0.00). FOIS improved from 1.13 (+/- 0.35) to 2.50 (+/- 0.75) at 1, 4.13 (+/- 1.64) at 3 and 5.13 (+/- 1.88) at 6 months (p=0.004). Improvement in oral intake was achieved in 100% (11/11) and feeding tubes were removed in 63% (7/11). VHI10 changed from 85. 87 (+/- 10.05) to 97.37 (+/- 12.38 SD) at 1, 69.87 (+/- 13.83) at 3 and 35.0 (+/- 7.58) at 6 months (p=0.006). FACT_HN improved from 88.85 (+/-6.47) to 91.62 (+/- 8.45) at 1, 114.62 (+/- 6.99) at 3 and 128.00 (+/- 5.38) at 6 months (p=0.002). Major complications of FL occurred in 0%.
Conclusion: Functional laryngectomy resulted in marked improvements in the self-perception of voice and swallowing, functional oral intake, and quality of life in head and neck cancer survivors with intractable aspiration. Two patients (15%) expired before undergoing laryngectomy. Improvement in oral intake was achieved in 100% and feeding tubes were removed in 63%.