Practitioner and patient outcomes
The following outcomes were considered: gender; age; primary tumor site;
cTNM classification; primary treatment; TL indication (primary, salvage,
second primary, and dysfunctional larynx); surgical characteristics
(e.g., neck dissection and flap reconstruction); driving distance to the
hospital; and survival outcome. The following data were collected for
each VP change: date of placement; change or removal; VP type and size;
reason for change or removal; and use of a washer for periprosthetic
leakage.
A patient-reported outcome questionnaire including 6 items was proposed
to patients at each VP change (Appendix 1). Items were assessed with a
10-point Likert-scale.
Results :
Ten patients completed the evaluations. The epidemiological and clinical
outcomes of patients are available in Table 1. There were 8 males and 2
females, respectively. The median age was 63.2 yo (range 48-79 yo). TL
was performed for the following indications: low-grade cricoid
chondrosarcoma (N=2); recurrent laryngeal cancer after radiation (N=3)
or chemoradiation (N=5).
Fifty-two VP changes were performed by the senior SLP during the study
period. The mean duration of the SLP consultation, including patient
history, examination and VP change procedure was 20 min (range: 15-30).
The median prosthesis life-time was 88 days. The main reasons for VP
changes were transprosthetic (N=34; 79%) and periprosthetic (N=7; 21%)
leakages, respectively. SLP successfully performed all VP changes. He
did not change one VP but used a periprosthetic silastic to stop the
periprosthetic leakages. In two cases, SLP needed the surgeon
examination to discuss about the following indication: implant mucosa
inclusion and autologous fat injection.
The patient satisfaction was high according to the speed and the quality
of care by the SLP (Table 2).