30 | Chapter 1 to explore the level of observed and perceived shared decision-making among head-andneck surgeons, patients, and their relatives within our own institute. By assessing the dynamics of decision-making processes in a localized setting, we aimed to gain insights into potential areas for improvement and optimization of patient care. Moving forward to Chapter 4, our attention turned specifically to patients with advanced laryngeal carcinoma who are confronted with curative treatment options. This investigation is a component of a larger multicenter study aimed at evaluating the impact of a patient decision aid tailored to this particular patient cohort. By examining the level of decisional conflict experienced by these individuals, we sought to ascertain the efficacy of interventions designed to support informed decision-making. Chapter 5 of this thesis investigated the impact of a Patient Decision Aid (PDA) for individuals facing advanced laryngeal cancer. We assessed how this tool influences treatment knowledge, decisional conflict and perceived shared decision-making. Finally, Chapter 6 details our efforts in the development of a PDA tailored specifically for individuals diagnosed with operable oropharyngeal carcinoma. By customizing decision support tools to address the unique needs and preferences of this patient population, we aimed to empower patients to actively participate in the decisionmaking process regarding their treatment options. Part 2: Rehabilitation after Total Laryngectomy Voice prostheses are crucial for laryngectomized patients, but they come with a limited device lifetime. In Chapter 7, we thoroughly explored the feasibility of prophylactic replacement strategies to address this challenge. Chapter 8 examined a newly developed voice prosthesis, meant to overcome biofilm destruction of the valve, focusing on its acceptance and voice quality among laryngectomized patients, providing valuable insights into its efficacy and usability. Moving forward to Chapter 9, we delved into the feasibility of Maximal Cardiopulmonary Exercise testing in laryngectomized patients, aiming to understand the physiological responses to exercise within this population. Additionally, we investigated the influence of Heat and Moisture Exchangers (HMEs) on exercise responses, shedding light on potential optimization strategies for respiratory health postlaryngectomy. And even after total laryngectomy, patients can still possess remarkable abilities. In Chapter 10, we shared an uplifting anecdote through a letter to the editor, highlighting the inspiring story of a laryngectomized patient who defies expectations by demonstrating an extraordinary ability to sing and play guitar.
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