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However, whether the physical impairments related to TL translate to a reduced health\u2010related quality of life (HRQoL) has not yet been determined. Therefore, the objective of this systematic review was to determine how HRQoL is affected following TL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Systematic searches were conducted in PubMed, Embase, and Cochrane. Inclusion criteria were original studies describing quality of life following TL after larynx\/hypopharynx cancer using a formally developed patient\u2010reported questionnaire. Study quality assessment was carried out with the tool developed by the National Heart, Lung, and Blood Institute.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010six studies using 12 different questionnaires were included. The majority were cross\u2010sectional (85%), and study quality was rated poor in 30%, fair in 30%, and good in 39% of studies. When comparing results from the four most frequently used questionnaires with normative data, we found that in more than 60% of studies, differences to the reference population were of clinical importance, with only few exceptions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In general, we found that people who received TL have a worse HRQoL than the male normative reference population. However, even though TL patients experience a clinically important difference in many domains when compared with normative data, their burden of symptoms is generally mild. The current review also makes it evident that despite the relatively large number of studies conducted, the strength of evidence remains weak. <jats:italic>Laryngoscope<\/jats:italic>, 131:820\u2013831, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29027","type":"journal-article","created":{"date-parts":[[2020,8,31]],"date-time":"2020-08-31T17:30:32Z","timestamp":1598895032000},"page":"820-831","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Health\u2010Related Quality of Life Following Total Laryngectomy: A Systematic Review"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7586-9216","authenticated-orcid":false,"given":"Nille B.","family":"Wulff","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Maxillofacial Surgery Zealand University Hospital  K\u00f8ge Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2705-5226","authenticated-orcid":false,"given":"Anna","family":"H\u00f8jager","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Maxillofacial Surgery Zealand University Hospital  K\u00f8ge Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9986-5001","authenticated-orcid":false,"given":"Irene","family":"Wessel","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery and Audiology Rigshospitalet, University Hospital of Copenhagen  Copenhagen Denmark"},{"name":"Institute of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5485-2730","authenticated-orcid":false,"given":"Susanne O.","family":"Dalton","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Danish Cancer Society Research Center  Copenhagen Denmark"},{"name":"Department of Clinical Oncology and Palliative Care Zealand University Hospital  N\u00e6stved Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2877-3518","authenticated-orcid":false,"given":"Preben","family":"Hom\u00f8e","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Maxillofacial Surgery Zealand University Hospital  K\u00f8ge Denmark"},{"name":"Institute of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199106133242402"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.43.6097"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21332"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otorri.2016.11.005"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-1-1"},{"key":"e_1_2_6_8_1","unstructured":"Covidence Systematic Review Software Veritas Health Innovation Melbourne Australia. 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