Comparison of Functional Outcomes after Endoscopic versus Open-Neck Supraglottic Laryngectomies

Abstract

Endoscopic supraglottic laryngectomy had a significantly lower functional impact on swallowing than ONSL, even though it was not subjectively perceived by patients, and was associated with less morbidity and a shorter hospitalization time.

Transoral Laser Surgery for Supraglottic Carcinoma

“…Aspiration is minimal and occurs in the early postoperative period only and there is a reduced need for secondary tracheostomy and laryngectomy due to aspiration problems. 15,16,20,25,26,34 Mechanisms contributing significantly to the recovery of swallowing function after supraglottic, either open or endoscopic laryngectomy are: the oropharyngeal transit time of the bolus, closure of the airway at the laryngeal entrance, the position of the laryngeal remnant in relation to the base of the tongue, and the movement of the base of the tongue toward the posterior pharyngeal wall. 33,35,36 Patients who regain these functions postoperatively meet the prerequisites for a normal swallowing function.…”

“…The incidence of postoperative hemorrhage is similar in both endoscopic and open approaches and ranges from 3% to 10%. 15,16 However, endolaryngeal bleeding in endoscopically treated, non tracheotomized patients is a serious and potentially lethal complication, not only because of the blood loss but also because of possible aspiration of blood, and hypoxia. …”

“…18 But it is known that incidence of aspiration pneumonia is variable and also depends on the patient's condition, including age and motivation. 15,16,19 The incidence of hemorrhage oscillated between 3 and 14%. 12,15,16,20 The incidence of postoperative hemorrhage is about equal for open supraglottic laryngectomy, SCPL-CHP, and laser microsurgery with an average between 3-14% in different studies.…”

“…15,16,19 The incidence of hemorrhage oscillated between 3 and 14%. 12,15,16,20 The incidence of postoperative hemorrhage is about equal for open supraglottic laryngectomy, SCPL-CHP, and laser microsurgery with an average between 3-14% in different studies. 12,15,20,21 However, every postoperative bleeding after endoscopic surgery in a non-tracheotomized patient is a serious and potentially life-threatening complication due to the risk of aspiration of blood.…”

Transoral Robotic Supraglottic Laryngectomy

“…Supraglottik bölgedeki görüş alanının kısıtlı olması ve cerrahi alet manüplasyonunun zorluğu bu yöntemin dezavantajlarıdır (12). Ayrıca, bu cerrahi teknik lazer ve mikroskobun bakış açısı ile sınırlı olduğu için preepiglottik yağ dokusunun diseksiyonu ve spesmenin bütün hâlde çıkarılması mümkün değildir (13).…”