Klaske van Sluis

Voice outcomes following total laryngectomy 55 Figure 3.3: Graph visualizing participants (%) with unsatisfactory (abnormal) scores over time for EQ-5D-5L, VHI-10, and AVQI. T3. When investigating individual course, a response shift is seen after surgery; Some participants expressed they were happy to be alive and satisfied with the fact that they can express themselves verbally, they indicate quality of the sound of the voice as less important, whilst during pre-surgery assessment their VHI-10 was clearly impaired. The mean AVQI score rising from 3.57 (SD1.69) at T0 to 8.07 (SD 2.77) at T2 indicates a clear deterioration of acoustic voice quality after surgery (Figure 2). At all assessment time points participants voices are dysphonic, with a mean AVQI score above 2.95. AVQI scores remain impaired and never reach baseline level again. Figure 3 shows that 58% of the participants have an AVQI score indicating impairment at T0, this increases to 100% at T1 and T2. At T3, numbers are still increased to 90% of the participants. A similar course of perceptual outcome evaluations by the clinician and the participant are found, T0 scores are: Perc. Voice SLP score 4.65 (SD 2.58), and Perc. Voice Pt score 4.65 (SD 2.58), deterioration is seen at T1, gradually improving over time. At the time-points T1-T3 mean Perc. Voice SLP scores are consistently about 0.5 points higher compared to the perceptual evaluation of the participant.