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Quality of Life following Total Laryngectomy: Assessment Using the UW-QOL Scale

Objectives: To determine the quality of life (QOL) in patients using valved speech following total laryngectomy with a validated patient self-report scale. Study Design: Cross-sectional cohort study. Patients: 63 patients following total laryngectomy using valved speech. Intervention: University of Washington Quality of Life (UW-QOL) questionnaire. Main Outcome Measures: Patient perception of the QOL over the last 7 days following total laryngectomy in response to specific questions and correlated with sociodemographic and treatment factors. Results: Responses were received from 44 males and 11 females (response rate: 87.3%) with a median age of 66 years (range: 40–84). The mean (SD) composite score of the QOL in our series of patients with total laryngectomy was 81.3 (10.9). As regards the overall QOL, 80% of our patients cited it as very good (45.5%) to good (34.5%). Patients identified speech, appearance, and activity as the most important issues following total laryngectomy. Only age and pharyngo-oesophageal segment closure were significant predictors of QOL scores (Student t test, p < 0.05) and not other demographic and treatment variables. Conclusions: The composite score and overall QOL were high in our series of total laryngectomy patients and this possibly reflects adequate multidisciplinary management. We strongly urge the use of prospective longitudinal studies that will adequately identify any QOL changes over time. Although the UW-QOL questionnaire is a simple and brief scale, it has limitations that can curtail its effective use in laryngectomy patients and we advise supplementing it with the use of domain-specific questionnaires.