Original Research Article
Year: 2020 | Month: September | Volume: 10 | Issue: 9 | Pages: 447-453
Examining the use of Voice Handicap Index in Patients with Pharyngeal Cancer Undergoing Organ Preservation
Smita Caren Mathias1, B.S. Premalatha2, Nimisha Nujum3, Naveen Chandrasekhar Hedne4
1PhD Research Scholar
2Professor, Department of Speech Language Studies, Dr S.R. Chandrashekhar Institute of Speech & Hearing, Bangalore, Karnataka, India.
3Biostatistician, B N Gupta Research Centre, Dr S.R. Chandrashekhar Institute of Speech & Hearing, Bangalore, Karnataka, India.
4Department of Head and Neck Oncology, Mazumdar Shaw Medical Centre, Narayana Health City, Bangalore, Karnataka, India.
Corresponding Author: B.S. Premalatha
ABSTRACT
Background: Patients with pharyngeal cancer have secondary complaints of voice change.
Aim: To study the impact of pharyngeal cancer and its treatment on the functional, physical, and emotional domains of the voice handicap index.
Methodology: This was a single center, prospective, case control study conducted over 2 years. Patients with pharyngeal cancer were studied before and after chemoradiation using the voice handicap index. Mann Whitney U, Wilcoxon signed ranked and Chi square tests were used for the statistical analysis.
Results: A total of twelve patients (nine men and three women) with a mean age and standard deviation of 58.50 ± 9.17 years were evaluated during study. The patients differed significantly (P< 0.05) from controls over all the three domains of the voice handicap index - functional, physical, and emotional – both before and after chemoradiation. There was a significant difference in the functional domain before and after treatment (P = .05) among patients. The voice handicap index was not associated with tumor staging, subsites, or node involvement. Pre-treatment, there was a significant difference in the functional domain (P = .02) and total score (P = .05) between the oropharynx and hypopharynx groups, however post-treatment no such difference was observed.
Conclusion: Tumour infiltration and/or radiation fields affect voice dynamically in pharyngeal cancers. Information from the functional, physical and emotional domains in the voice handicap index must be incorporated during pre-treatment counseling to set realistic expectations. It should also aid in timely voice assessments and rehabilitation before and after treatment.
Key words: Voice handicap index, Pharyngeal cancer, Organ preservation, Chemoradiation, Quality of life, Voice rehabilitation