Informing patient choice and service planning in surgical voice restoration: valve usage over three years in a UK head and neck cancer unit

J Laryngol Otol. 2022 Feb;136(2):158-166. doi: 10.1017/S0022215121004060. Epub 2021 Dec 9.

Abstract

Objective: This study aimed to determine the number, reasons and costs of surgical voice restoration related tracheoesophageal valve attendances over 36 months at a head and neck oncology unit.

Method: Demographic, medical and valve related details from all patient contacts were recorded, including self-change information, urgent appointment information, modifications required and costs of prostheses.

Results: Over 3 years, 99 patients underwent 970 valve changes. The main reasons for changes were central leakage, prophylactic change and self-change at home. Changes were significantly more frequent in the first 12 months (mean, 42 days) compared with longstanding patients (mean, 109.96). Intervals between changes were unpredictable; no predictive factors reached statistical significance. Mean expenditure on valves was £966.63 per week (including value added tax and in-house customisation).

Conclusion: Valve lifespan is comparable with outcomes in similar units despite more pre-emptive and patient-led changes and more comprehensive data inclusion. Investigation into how patient satisfaction and costs relate to valve selection and units' service delivery models is needed.

Keywords: Alaryngeal; Artificial; Head And Neck Neoplasms; Laryngectomy; Larynx; Speech.

MeSH terms

  • Adult
  • Aged
  • Esophagus / surgery*
  • Female
  • Head and Neck Neoplasms / surgery*
  • Health Services / statistics & numerical data
  • Humans
  • Laryngectomy / rehabilitation*
  • Larynx, Artificial*
  • Male
  • Middle Aged
  • Patient Preference
  • Patient Satisfaction
  • Plastic Surgery Procedures
  • Speech, Alaryngeal*
  • Speech-Language Pathology
  • Trachea / surgery*
  • United Kingdom