Functional Oral Intake in Primary Versus Salvage Laryngectomy.
Otolaryngol Head Neck Surg
; 171(3): 756-763, 2024 Sep.
Article
en En
| MEDLINE
| ID: mdl-38769874
ABSTRACT
OBJECTIVE:
Advanced-stage laryngeal squamous cell carcinoma is treated with primary surgery or chemoradiation. We aim to determine if there are differences in postoperative functional oral intake in primary (PL) versus salvage laryngectomees (SL). STUDYDESIGN:
Retrospective cohort study.SETTING:
Patients who underwent laryngectomy between 2011 and 2021.METHODS:
We examined demographic, diagnostic, treatment, and swallow function data pre- and postoperatively. A follow-up survey was distributed to assess current swallow status.RESULTS:
One hundred twenty-five patients were included. Preoperatively, 68.8% of patients reported dysphagia. Median functional oral intake score (FOIS) was 4.0 [interquartile range, IQR 1.0-6.75]. The SL group had lower preop FOIS [2.0; IQR 1.0-4.75] that did not reach significance compared to the PL group [4.5; IQR 1.0-7.0] (P = .052). 73.4% of patients had a feeding tube. The PL group was more likely to have the tube removed [odds ratio, OR 2.4; confidence interval, CI 1.0-5.7]. The SL group was more likely to require feeding tube placement more than 6 months postop [OR 6.9; CI 1.65-32.6]. SL FOIS scores improved by 3 months postop to 5 (SL ΔFOIS = 3, P = .0150). PL scores improved to 7 [PL ΔFOIS = 2, P = .0005] at 12 to 15 months. Sixty-nine patients were contacted for a follow-up survey and 16 completed this survey. 30.4% patients reported dietary restrictions (mean 4.4 years postop).CONCLUSION:
Patients undergoing SL appear to obtain similar swallow outcomes compared to PL at 3 to 6 months postlaryngectomy, but plateau. The PL group continues to improve up to 1 year postoperatively. Fifty percent of patients report on-going dysphagia after 5 years.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Trastornos de Deglución
/
Neoplasias Laríngeas
/
Terapia Recuperativa
/
Laringectomía
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Otolaryngol Head Neck Surg
Asunto de la revista:
OTORRINOLARINGOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Reino Unido