Klaske van Sluis

CHAPTER 1 General introduction 1.1 Introduction This thesis focuses on individuals who have had head and neck cancer and had to undergo a surgical procedure called total laryngectomy. This is an organ- sacrificing surgery which leads to lifelong consequences in anatomy and phys- iology of the body. During the total laryngectomy procedure, the larynx is removed, which leads to a loss of the natural voice. Our mission with this the- sis is to contribute to better understanding of voice and speech outcomes after total laryngectomy as well as the functional and participation issues which af- fect well-being. Based on these findings I aim to identify rehabilitation gaps and formulate recommendations to improve clinical practice and ongoing research. The thesis is divided into two sections. The first chapters focus on voice and speech outcomes after total laryngectomy. The second part of this thesis focuses on functional issues and psychosocial functioning after total laryngectomy. This introductory chapter will help the reader understand the consequences of a total laryngectomy. The available speech rehabilitation options will be discussed as well as the tools to evaluate quality of voice and speech outcomes. This is followed by a section on the functional and participation issues which total laryngectomy patients face.