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).