Quality of Life After Total Laryngectomy

Objectives: To use the framework proposed by the International Classification of Functioning, Disability and Health (ICF) to review outcomes related to quality of life (QOL) after total laryngectomy. Patients/Materials and Methods: Results from papers published on QOL after total laryngectomy were organized according to the ICF framework. Outcomes were summarized relative to the contribution of disease and treatment-related factors, those related to changes in body functions and structures, activities, and participation, and those related to contextual factors such as family and social support, and personal variables such as coping strategies, age, and gender. Results: QOL after total laryngectomy is multidimensional. Outcomes are affected by management of the airway (stoma), success of alaryngeal speech and communication, and swallowing. Factors related to treatment (absence or presence of radiation or chemotherapy), those related to one’s environment (family and social support), and/or person (depression, coping strategies, age, and gender) are interactive and also predict outcomes. Longitudinal studies that include psychosocial variables are lacking. Conclusions: The type of instrument used to assess quality of life, time after diagnosis, and study design must be considered when interpreting QOL postlaryngectomy. There is a continued need to perform multi-center, prospective studies to increase levels of evidence after treatment for advanced laryngeal cancer to ensure the most beneficial treatment for each individual is pursued.