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      Correlação da desvantagem vocal e qualidade de vida em deglutição de pacientes com câncer de laringe submetidos à quimiorradioterapia Translated title: Correlation between the Voice Handicap and Swallowing Quality of Life in patients with laryngeal cancer submitted to chemoradiotherapy

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          Abstract

          RESUMO Objetivo Verificar a correlação entre desvantagem vocal e a qualidade de vida em deglutição de indivíduos que foram submetidos ao tratamento quimiorradioterápico para câncer de laringe. Método Estudo transversal, observacional e quantitativo do qual participaram 14 indivíduos do gênero masculino diagnosticados com câncer de laringe, que, para tratamento, fizeram uso exclusivo de quimiorradioterapia. Aplicaram-se os instrumentos Índice de Desvantagem Vocal e Protocolo de Qualidade de Vida em Deglutição SWAL-QoL. Fez-se análise descritiva e, em seguida, aplicou-se o teste de Correlação de Spearman para verificar se havia correlação entre os escores dos instrumentos aplicados. Foram considerados estatisticamente significativos os valores de p ≤ 0,05. Resultados Não houve correlação significativa entre os domínios total do IDV e global do SWAl-QoL, porém houve correlação significante entre os domínios “Funcional” do IDV e os domínios “Fadiga” e “Social” do Swal-Qol; domínio “Orgânico” do IDV com o domínio “Social” do SWAL-QoL; escore total do IDV, com o domínio de “Deglutição como um fardo” do SWAL-QoL. Além disso, foi possível observar que o tratamento quimiorradioterápico ocasionou maior impacto em relação à voz do que em relação à deglutição para os pacientes estudados. Conclusão Os dados demonstraram correlação significante entre a desvantagem vocal e o impacto da qualidade de vida em deglutição de pacientes com câncer de laringe submetidos à quimiorradioterapia, podendo afetar seu estado emocional e sua socialização, piorando assim, sua qualidade de vida de modo geral.

          Translated abstract

          ABSTRACT Purpose To verify the correlation between the voice handicap and swallowing quality of life in individuals submitted to chemoradiotherapy for laryngeal cancer treatment. Methods Cross-sectional, observational and quantitative study. Fourteen male individuals diagnosed with laryngeal cancer were submitted to exclusive chemoradiotherapy treatment. The individuals completed the Voice Handicap Index (VHI) and the Swallowing Quality of Life (SWAL-QOL) questionnaires. Data were submitted to descriptive and inferential analysis using Spearman’s Correlation Test to verify possible correlations among the scores of these instruments. Values of p ≤ 0.05 were considered statistically significant. Results No significant correlation was found between the total VHI and overall SWAL-QOL scores. However, there was significant correlation between the domain Functional of the VHI and the domains Fatigue and Social of the SWAL-QOL, between the domain Organic in the VHI and the SWAL-QOL domain Social, and total VHI score and SWAL-QOL domain Swallowing as a burden. Furthermore, chemoradiotherapy treatment had a greater impact on the voice than on the swallowing for the studied individuals. Conclusion The data showed a significant correlation between voice handicap and the impact of quality of life involving swallowing in individuals with laryngeal cancer submitted to chemoradiotherapy. This may affect individuals’ emotional and social aspects, impacting their overall quality of life.

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          Validation of the Voice Handicap Index: 10 (VHI-10) to the Brazilian Portuguese

          PURPOSE: To validate the Voice Handicap Index - 10 (VHI-10) into Brazilian Portuguese and to check its psychometric measures. METHODS: The validation was performed following the guidelines suggested by the Scientific Advisory Committee of the Medical Outcomes Trust. A hundred ten individuals participated, 60 with vocal complaint, 6 males and 54 females, with age ranging from 21 to 82 years; and 50 without vocal complaint, 6 males and 44 females, age ranging from 18 to 87 years. The procedures performed were a voice self-assessment and the VHI-10. For the self-assessment, the individuals evaluated their vocal quality by means of a five-point scale: excellent, very good, good, fair and poor. The VHI-10 was administered twice to 30 of the 60 individuals with vocal complaint to determine the test-retest reproducibility. For checking the sensitivity, the VHI-10 was administered to 21 patients that underwent voice rehabilitation. RESULTS: The validity was determined by comparing the total score with the self-assessment results. Individuals that classified their voice as poor had a total score of 28.2 (standard deviation=8). Internal consistence was determined with high values of coefficient (p<0.001). Results showed a high level of reproducibility (p=0.0114). Sensitivity was demonstrated with a significant difference between pre and post-rehabilitation results (p<0.005). CONCLUSION: The VHI-10 is an instrument validated into Brazilian Portuguese, with psychometric measures of validity, reliability and sensibility proven and can be applied to individuals with voice problems.
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            Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises.

            Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in HNC survivors, long-term (i.e., beyond 5 years) prospectively collected data on objective and subjective treatment-induced functional outcomes (and their impact on QoL) still are scarce. The objective of this study was the assessment of long-term CCRT-induced results on swallowing function and voice quality in advanced HNC patients. The study was conducted as a randomized controlled trial on preventive swallowing rehabilitation (2006-2008) in a tertiary comprehensive HNC center with twenty-two disease-free and evaluable HNC patients as participants. Multidimensional assessment of functional sequels was performed with videofluoroscopy, mouth opening measurements, Functional Oral Intake Scale, acoustic voice parameters, and (study specific, SWAL-QoL, and VHI) questionnaires. Outcome measures at 6 years post-treatment were compared with results at baseline and at 2 years post-treatment. At a mean follow-up of 6.1 years most initial tumor-, and treatment-related problems remained similarly low to those observed after 2 years follow-up, except increased xerostomia (68%) and increased (mild) pain (32%). Acoustic voice analysis showed less voicedness, increased fundamental frequency, and more vocal effort for the tumors located below the hyoid bone (n = 12), without recovery to baseline values. Patients' subjective vocal function (VHI score) was good. Functional swallowing and voice problems at 6 years post-treatment are minimal in this patient cohort, originating from preventive and continued post-treatment rehabilitation programs.
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              Dysphagia, Speech, Voice, and Trismus following Radiotherapy and/or Chemotherapy in Patients with Head and Neck Carcinoma: Review of the Literature

              Introduction. Patients with head and neck cancer suffer from various impairments due to the primary illness, as well as secondary consequences of the oncological treatment. This systematic review describes the effects of radiotherapy and/or chemotherapy on the functions of the upper aerodigestive tract in patients with head and neck cancer. Methods. A systematic literature search was performed by two independent reviewers using the electronic databases PubMed and Embase. All dates up to May 2016 were included. Results. Of the 947 abstracts, sixty articles met the inclusion criteria and described one or more aspects of the sequelae of radiotherapy and/or chemotherapy. Forty studies described swallowing-related problems, 24 described voice-related problems, seven described trismus, and 25 studies described general quality of life. Only 14 articles reported that speech pathologists conducted the interventions, of which only six articles described in detail what the interventions involved. Conclusion. In general, voice quality improved following intervention, whereas quality of life, dysphagia, and oral intake deteriorated during and after treatment. However, as a consequence of the diversity in treatment protocols and patient characteristics, the conclusions of most studies cannot be easily generalised. Further research on the effects of oncological interventions on the upper aerodigestive tract is needed.
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                Author and article information

                Journal
                codas
                CoDAS
                CoDAS
                Sociedade Brasileira de Fonoaudiologia (São Paulo, SP, Brazil )
                2317-1782
                2018
                : 30
                : 2
                : e20170060
                Affiliations
                [01] Florianópolis Santa Catarina orgnameUniversidade Federal de Santa Catarina orgdiv1Curso de Fonoaudiologia Brazil
                Article
                S2317-17822018000200310 S2317-1782(18)03000200310
                10.1590/2317-1782/20182017060
                29791614
                2b159c81-c078-4c59-84fa-c6396b6ebd94

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 01 October 2017
                : 16 March 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 0
                Categories
                Artigos Originais

                Voz,Efeitos de Radiação,Radiation Effects,Qualidade de Vida,Transtornos de Deglutição,Voice,Swallowing Disorders,Quality of Life,Chemoradiotherapy,Quimiorradioterapia

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