Background:
Use of a voice prosthesis (VP) together with a heat-moisture exchange system (HME) is currently considered to provide optimal voice and pulmonary function following total laryngectomy. We investigated how demographic factors (age, sex, employment, commute, living circumstances) influenced their use.
Methods:
Secondary analysis was performed on data from 1216 patients post-total laryngectomy (PTL) from England/Wales. 633 patients used voice prostheses with HME.
Results:
Men in full-time employment had optimal communication and pulmonary outcomes (83%).
PTL’s age range was 28-97, mean age 69.6 years, majority (68%) ‘retired’, with 7% unemployed (national average of 3.8% – 0NS Census, 2021). Given missing data (12%) and sick leave (2%), this figure may be greater.
Fewer unemployed PTL use VPs/HMEs.
Differences between sexes were noted, fewer females used VPs and HMEs (the latter did not reach statistical significance).
‘Commute’ to centre from home was > 5 miles for most patients (73%) which did not impact on rehabilitation, with equivalent HME and VP use, but could influence support-group attendance which enables acceptance of TSV and HME.
Care-home residents were least likely to use either VP (42%) or HME (42%).
Conclusion
This audit identified PTLs requiring greater support from the MDT, e.g. unemployed, females, care-home residents.
Carol Glaister1, Jo Patterson2, Kate Baker3, Jane Dunton4, Elizabeth Rowe5, Sarah Woodman6, Roganie Govender7
1 Department of Speech & Language Therapy, Head & Neck, Royal Victoria Eye & Ear Hospital, Dublin
2 Department of Speech & Language Therapy, Head & Neck, Liverpool University, United Kingdom
3 Department of Speech & Language Therapy, Head & Neck, The Royal Marsden Hospital, UK
4 Department of Speech & Language Therapy, Head & Neck Oncology, Guy’s & St Thomas’ NHS Foundation Trust, UK
5 Department of Speech & Language Therapy, Head & Neck Oncology, Chesterfield Royal Hospital NHS Foundation Trust, UK
6 Department of Speech & Language Therapy, ENT/Head & Neck, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, UK
7 Department of Speech & Language Therapy, Head & Neck Cancer, University College London, UK