Reconstruction technique following total laryngectomy affects swallowing outcomes

Brianna N. Harris, Steven G. Hoshal, Lisa Evangelista, Maggie Kuhn

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives: How reconstruction affects function following total laryngectomy is unclear. This study seeks to determine whether reconstruction method is associated with differences in swallowing outcomes. Methods: Retrospective review of reconstruction technique in patients undergoing TL was compared by pharyngeal transit time (PTT), patient-reported dysphagia (EAT-10), and diet-tolerated (FOIS). Results: Ninety-five patients met inclusion criteria, with 40 patients (42.1%) undergoing primary closure and 55 patients (57.9%) undergoing tissue transfer. There was no difference in EAT-10 scores between the groups (P =.09). There was a significantly higher proportion of patients achieving oral diet (FOIS >3) with primary closure (P =.003). Patients undergoing PMC vs free flap had similar rates of g-tube dependency. Primary closure had the shortest PTT (1.89 seconds) compared to free flap (3.47-4.65 seconds) or PMC (5.1 seconds; P =.035). Conclusions: When primary closure is achievable, these results suggest improved swallowing outcomes with better tolerance of oral diet and shorter pharyngeal transit times. Level of evidence: IV.

Original languageEnglish (US)
Pages (from-to)703-707
Number of pages5
JournalLaryngoscope investigative otolaryngology
Volume5
Issue number4
DOIs
StatePublished - Aug 1 2020

Keywords

  • dysphagia
  • head and neck cancer
  • microvascular reconstruction
  • total laryngectomy

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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