Comparison of Voice Handicap Index in Patients with Esophageal and Tracheoesophageal Speech after Total Laryngectomy

Abstract

Background: Successful speech rehabilitation has a great impact on the quality of life in totally laryngectomized patients.

Objectives: The aim of this paper was to compare the self-assessed voice handicap of totally laryngectomized patients with two different methods of alaryngeal speech - esophageal (ES) and tracheoesophageal speech (TES).

Method: The research comprised 83 totally laryngectomized, disease-free patients, split into two groups. The first group included 43 participants with successfully rehabilitated ES, and the second group included 40 participants with successfully established TES after secondary implantation of Provox 2TM voice prosthesis. All subjects filled in the Serbian version of the Voice Handicap Index (VHI-30). The results (overall score and three VHI subscales) were analyzed and compared with those of the subjects of both groups. The impact of age in the subgroups (<65 years old and ≥65 years old) and previous irradiation on the examined VHI values were also analyzed.

Results: The median value of the overall VHI score in the participants with TES was 29.03 ± 23.479 (range: 0-97), and in the participants with ES it was 64.51 ± 21.089 (range: 19-99). The VHI scores (overall and three VHI subscales) were significantly higher in participants with ES compared to those with TES (p < 0.01), indicating a larger voice handicap. No significant difference was found in the overall VHI score and VHI subgroups in terms of age subgroups and previous irradiation (p > 0.05).

Conclusions: Our data reveal a significantly higher voice handicap in participants with ES compared to the TES group, with a large interindividual variation within both groups. VHI values are not significantly different between the two age subgroups, nor are they significantly influenced by irradiation.

Keywords: Esophageal speech; Total laryngectomy; Tracheoesophageal speech; Voice handicap.