Abstract:
Head and Neck Cancer (HNC) in the world, and even more in developing countries (e.g.,
Bangladesh), where awareness and rehabilitative care were meager. Malignancies of the
oral cavity, pharynx, and larynx (HNC) compromised several dimensions of
communication and emotional well-being due to both aggressive tumor local invasion and
potential treatment modality sequela (surgery, radiotherapy, and chemotherapy).
The current study was conducted to assess the severity, quality, and effects of voice
problems among HNC patient’s daily lives in Bangladesh. It was a cross-sectional design
with purposive sampling for data collection from three major cancer hospitals. The Voice
Handicap Index-10 (VHI-10) and GRBAS Scale were assessed in 185 subjects.
As for voice problems classification were using the VHI-10, the study demonstrated that
28.6% patients presented as normal, whereas mild and moderate voice problems were
demonstrated in 22.7% and 25.4% patients respectively, and severe voice disorder in
23.2% patients. Quality of voice was graded as per GRBAS scale and 28.1% had severe
abnormality of voice quality, 20.5% had moderate abnormality, 26.5% had mild
abnormality and 24.9% normal voice. They also found functional, physical, and emotional
impairment, including difficulty being heard (27.6%), shortness of breath when speaking
(23.2%), and anxiety around communication (25.9%). None of the subjects had undergone
voice therapy or visited SLT, interestingly.
This data indicated a high burden and impact of voice problem among HNC patients in
Bangladesh but pointed to an unaddressed gap in rehabilitation services. SLTs were
crucial in identifying, managing and supporting these individuals. These findings
emphasized the need for timely voice rehabilitation, better accessed to voice rehabilitation
through SLT and further education of both patients and healthcare professionals were
regarding voice rehabilitation.
Keywords: Head and Neck Cancer, Voice problems, Chemotherapy, Radiotherapy,
Surgery, Voice Handicap Index-10 (VHI-10), GRBAS Scale
Description:
This dissertation is submitted in partial fulfillment of the requirements for the Degree of Bachelor of Science in Speech and Language Therapy, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh.
