Voice rehabilitation for laryngeal cancer patients: Functional outcomes and patient perceptions

Liza Bergström, Elizabeth C Ward, Caterina Finizia

Laryngeal cancer and its treatment, despite management with organ-preservation treatments, is known to negatively affect voice and functional outcomes. The aim of this study was to determine whether functional outcomes and patient perceptions were improved by combining organ preservation with post treatment function rehabilitation. Randomized controlled trial. Sixty-one patients with carcinoma in situ (Tis) to T4 size laryngeal cancers treated with radiotherapy were prospectively recruited. Thirty patients were randomized into the voice rehabilitation (VR) group and 31 received no VR (control group). The VR group underwent 10 speech pathology sessions postradiotherapy. Voice function was evaluated pre-VR and at 6 and 12 months follow-up using the auditory-perceptual Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale and patient perception measures. The control group demonstrated significant deterioration in vocal roughness (P = 0.02) between 6 to 12 months, whilst the VR group did not, resulting in a significant difference (P < 0.01) between the two groups at 12 months. A between-group significant difference (P = 0.02) was also observed for breathiness at 12 months. Patient perceptions of improved vocal quality, acceptability, hoarseness, vocal fatigue, and ashamed (of voice) pre- to post-VR improved significantly (P < 0.02) in the VR group, although significant difference (P = 0.03) between groups was observed post-VR for hoarseness only. For this study group representing Tis to T4-size laryngeal cancers, patients receiving voice rehabilitation post radiotherapy demonstrated no functional decline in vocal roughness and perceived their voice to improve to a greater extent post-VR than the control group. 1b. Laryngoscope, 2016.