Rehabilitation after major head and neck surgery?the patients' view

Abstract

Patients (49) who were free of tumor 5 mo.-14 yr (mean 30 mo.) after total laryngectomy or a commando procedure were given questionnaires designed to obtain the patient''s assessment of their resulting disability. Sixteen areas of disability were studied grouped under 5 main headings: speech, eating, cosmetic, employment and social. Following laryngectomy more than half of the patients achieved successful communication by esophageal speech. Success in this was usually associated with minimal problems in other areas. Disabilities after commando procedures were more varied and complex. More patients reported severe disability in more than 1 area. Difficulties with chewing and swallowing were prominent. Results are illustrated with patients'' comments. Ways in which rehabilitation might be improved are considered.