Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Assessing Quality of Life after Total Laryngectomy: A Systematic Review of Tools to Guide Personalized Rehabilitation

Document Type : Systematic Review

Authors
Valeria Terruso 1
Barbara Verro 2
Maria Novella Fiamingo 3
Simona Vitale 3
Carmelo Saraniti 2
1 Independent Speech and Language Therapist, Palermo, Italy.
2 Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90127 Palermo, Italy.
3 Speech therapist University Hospital G. Rodolico, Catania, Italy.
10.22038/ijorl.2026.97756.4222
Abstract
Objective
Total laryngectomy profoundly affects voice, swallowing, breathing, and social participation, with major physical, emotional, and psychological consequences. This systematic review evaluated quality of life (QoL) assessment tools used after total laryngectomy, focusing on their frequency of use, the domains assessed, and their limitations to support a comprehensive, patient-centered evaluation.
Data Sources
A systematic search of PubMed, the Cochrane Library, Google Scholar, and CORE identified studies published between 2015 and 2025 using the following keywords: total laryngectomy, laryngeal cancer, laryngectomized patients, quality of life, self-evaluation, and quality of life assessment.
Methods of Review:
A systematic literature search was performed according to predefined inclusion and exclusion criteria. After duplicate removal and title and abstract screening, full-text articles were independently assessed by two reviewers. Twenty-six studies were included in the qualitative synthesis.
Results
Among the included studies, 73% were observational and 20% were conducted in Italy. Twenty-six patient-reported outcome measures (PROMs) and complementary instruments were identified, with a mean of 2.8 instruments per study. Internationally, the VHI-30 was the most frequently used PROM (35%), followed by the SECEL and VR-QoL (31% each), whereas VR-QoL predominated in Italian studies (60%). QoL was generally poorest in the immediate postoperative period and improved over the following 8-21 months, although psychological distress frequently persisted. Voice rehabilitation, perioperative speech therapy, complication management, and social support were consistently associated with better outcomes.
Conclusions
Current QoL assessment remains heterogeneous and lacks a comprehensive multidimensional approach. Standardized, patient-centered evaluation integrating functional, psychological, and social domains is needed to better guide individualized rehabilitation after total laryngectomy.
Keywords
Total laryngectomy
Quality of life
Voice quality
Questionnaire
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 38, Issue 6
November and December 2026
Pages 369-382