Impact of total laryngectomy on return to work.

INTRODUCTION: Total laryngectomy is one of the most mutilating oncological operations. There are no specific studies evaluating return to work after this surgery.

PATIENTS AND METHODS: A cross-sectional study was performed on a sample of 116 laryngectomized patients who were disease- free and had a minimum follow-up of 2 years from total laryngectomy. A survey was conducted to find out their employment situation before and after surgery. At the time of surgery, 62 (53%) were working, 40 (35%) were retired and 14 (12%) were in a disability situation.

RESULTS: 60% had professions with low qualification requirements, the largest group being construction workers. Of the 62 patients active at the time of total laryngectomy, 29 became inactive and 33 (53%) maintained their work activity. The most important factors in maintaining work activity were the level of professional qualification and the method of vocal rehabilitation. Eighty percent of the patients with high-intermediate qualification maintained their jobs, compared to 35% of those with low professional qualifications (P<.001). Seventy percent of the patients with voice prostheses maintained their work activity, compared to 31% of the patients rehabilitated with oesophageal voice (P=.004). Logistic regression confirmed these as independent variables for continuing to work.

CONCLUSIONS: This is the first study that analyzes the impact of total laryngectomy on the work situation. The most important factors for a return to work were having a high-intermediate skilled job and the use of voice prosthesis as a method of vocal rehabilitation.