Journal article
Safety and efficacy of functional laryngectomy for end-stage dysphagia
The Laryngoscope, v 128(3), pp 597-602
Mar 2018
PMID: 28714539
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives/HypothesisTo evaluate functional outcomes and complication rate after total laryngectomy (TL) for dysfunctional larynx with end-stage dysphagia.
Study DesignRetrospective chart review.
MethodsChart review was performed on all patients who underwent TL from January 2008 to July 2016 at a single tertiary academic medical center. Patients who underwent TL for dysfunctional larynx without preoperative evidence of malignancy were included. Main outcome measures were post-TL functional swallowing and speech outcomes, and complication rate.
ResultsThe study included 19 patients from a cohort of 278 consecutive patients. All patients were previously treated with radiotherapy (RT), whereas 13/19 (68%) previously received chemoradiotherapy. The median time from RT to TL was 10.98 years (range, 0.67-23.94 years). Aspiration was evident preoperatively in 17/19 (89%) patients, with 11 experiencing recurrent aspiration pneumonia. Seventeen of 19 (89%) patients were nil per os (NPO) requiring enteral nutrition. Six of 19 (32%) patients had surgical complications, including three (16%) pharyngocutaneous fistulas. At 3-month and 1-year postoperative follow-up, there was significant improvement in mean Functional Oral Intake Scale (FOIS) score and aspiration, recurrent pneumonia, enteral nutrition, and NPO status rates (P<.05). At 1-year follow-up, no patients were NPO, and only one patient required gastrostomy tube supplementation. Mean FOIS score increased from 1.3 to 6.1 (P=.001). Eight of 13 patients (62%) were actively using a tracheoesophageal prosthesis at 1-year follow-up.
ConclusionsLaryngectomy for dysfunctional larynx eliminates the morbidity of aspiration while improving diet and reducing gastrostomy tube dependence with an acceptable complication rate.
Level of Evidence4. Laryngoscope, 128:597-602, 2018
Metrics
Details
- Title
- Safety and efficacy of functional laryngectomy for end-stage dysphagia
- Creators
- Michael C. Topf - Thomas Jefferson UniversityLinda C. Magana - Thomas Jefferson UniversityKelly Salmon - Thomas Jefferson UniversityJames Hamilton - Thomas Jefferson UniversityWilliam M. Keane - Thomas Jefferson UniversityAdam Luginbuhl - Thomas Jefferson UniversityJoseph M. Curry - Thomas Jefferson UniversityDavid M. Cognetti - Thomas Jefferson UniversityMaurits Boon - Thomas Jefferson UniversityJoseph R. Spiegel - Thomas Jefferson University
- Publication Details
- The Laryngoscope, v 128(3), pp 597-602
- Publisher
- Wiley
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Speech - Language Institute; Speech-Language Pathology
- Web of Science ID
- WOS:000425156200016
- Scopus ID
- 2-s2.0-85024894841
- Other Identifier
- 991022025321104721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Medicine, Research & Experimental
- Otorhinolaryngology