Total laryngectomy is the standard of care for advanced laryngeal/hypopharyngeal cancer. Effective voice rehabilitation is mandatory and tracheo-oesophageal speech (TES) has progressively gained approval. In 2011, we evaluated quality of life (QoL) and satisfaction after TES rehabilitation, demonstrating its efficacy in highly motivated subjects. The aim of the present study was to investigate whether those results are maintained over time within the same selected cohort. 15 of 24 patients were left with a minimum 12 year-follow up after voice prosthesis (VP) implantation. Short Form 36-Item Health Survey (SF-36) for QoL assessment and a study-specific structured questionnaire for evaluation of TES-related satisfaction were employed. The 9/24 patients who dropped out from the follow-up were excluded from the original count and the former results were recalculated. A control group of subjects with minor ENT diseases was used for SF-36 analysis. Many SF-36 items (RP, BP, SF, RE) significantly improved over time, approaching the results of the control group. VP duration also increased (6.3 ± 3.1 against 3.0 ± 1.8 months). TES-related satisfaction items did not change in a statistically significant way. Three patients (20.0%) would not have chosen the same kind of voice restoration: these subjects are those more distant from our institution (230 km and 462 km, respectively, against a mean distance of 15.4 ± 13.8 km for other patients). With the present work, we highlight how the striking results of TES can not only be maintained over time (i.e. TES-related satisfaction), but also substantially improve (i.e. QoL). An integrated, widespread network of centres for VP management is needed to optimise patient follow-up and allow studies on larger series.

Objective/Hypothesis: The purpose of the study was to assess the satisfaction and quality of life in laryngectomees after vocal rehabilitation using voice prostheses. We evaluated the impact on quality of life between laryngectomees with voice prostheses, laryngectomees without them and healthy controls. Methods: This was a prospective study on a sample of laryngectomees in an Italian university hospital. Our study population was composed of 42 patients who had previously undergone a total laryngectomy; in 24 of them, voice rehabilitation was obtained with a voice prosthesis device (group A), while 18 of them learned oesophageal voice (group B). The results were compared with a group of 25 healthy controls (group C). In order to investigate the quality of life, we administered the Short Form 36-Item Health Survey (SF-36) to the 3 groups. Moreover, self-satisfaction of the subjects in group A was assessed by single questions regarding their use of the voice prosthesis. Results: A statistical difference in the SF-36 was detected for social functioning (SF) between groups A and B. Role physical, SF and role emotional were significantly better in group C than in group A. Group A stated they were very satisfied with voice quality while there were still some problems regarding prosthesis lifetime and communication at the telephone or in noisy environments. Conclusions: Voice prosthesis implantation in laryngectomees showed positive effects on patients’ quality of life; however, there are still some negative aspects. At present, an early diagnosis of larynx cancer with a partial laryngectomy in order to preserve phonatory function is the gold standard.