The current study retro specti vely review ed the cases of 68 patient s who had undergone total laryn gectomy and tracheoesophageal pun cture (TEP) ove r a lo-year period. Fifty-one patients under went p rimary TEP and i 7 underw ent seconda ry TEP. Nearly 80% of pati ents who received TEP at the time of laryngectomy achieved excellent voice quality perceptu ally. in contrast, only 50% of secondary TEP patients achieved excellent voice ratings. This diff erence was statistically robust (p = 0.03). A lthough both surgical and prosthesis-related comp lications occurred more fre quently fo llo wing prim ary TEp, statistically significant differences were not achieved. Neith er pre-nor p ostoperati ve radi oth erapy had any effe ct on voice restoration or complication rates. Based on thes e data, p rimary TEP may be pref erable fo r several reasons, ineluding a greater likelihood ofsuccessful voice restorati on, a sho rter duration ofpostoperat ive aphonia, and the elimination ofthe needf or a second opera tion and interim tube f eedin gs.

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Background Transoral robotic surgery (TORS) has been utilized to deintensify treatment. No studies have measured swallow safety and efficiency, nor assessed the functional impact of TORS alone. Methods This prospective cohort underwent baseline and 1‐month postsurgery assessments including modified barium swallow evaluation, using the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) rating system, tongue range of motion assessment, the Performance Status Scale (PSS), and quality of life with the MD Anderson Dysphagia Inventory (MDADI). Results All DIGEST safety scores were 0 (normal) at both time points. DIGEST efficiency scores were mildly impaired in 2 of 10 patients postsurgery. PSS scores revealed all patients were on regular diets, were 100% understandable, and were eating in public at both time points. Tongue Range of Motion scores were 100 of 100 at both time points. MDADI scores were not significantly different across time points. Conclusions Careful identification of patients can result in excellent outcomes following TORS. Future studies will examine longer follow‐up of speech, swallowing, and tongue function in patients undergoing TORS surgery.

Our findings suggest that a single-trial design is sensitive to delineate a widespread neural network of activation in both hemispheres associated with rehabilitation tasks. Both the Effortful swallow and Mendelsohn maneuvers elicited significantly higher responses in regions related to swallowing, suggestive of enhanced cortical activation during these tasks.