Deglutition after supracricoid laryngectomy: Compensatory mechanisms and sequelae

Woisard, Virginie; Puech, Michel; Yardeni, E.; Serrano, É.; Pessey, J.-J.

doi:10.1007/bf00265213

Cited by 41 publications

(46 citation statements)

References 8 publications

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“…Furthermore, food might collect around the arytenoids thus, increasing the risk of aspiration. 12,13 To minimise PP, elderly patients and those with poor pulmonary function tests are considered not eligible for conservative laryngeal surgery because of the high risk of aspiration, due to a decreased ability to cough and clear secretions. Despite this selection, PP still represents the most frequent potentially life-threatening complication in partial laryngectomized patients, requiring more intensive care, delay rehabilitation and discharge from the hospital and inevitably leading to greater health care costs.…”

Section: Discussionmentioning

confidence: 99%

Prognostic role of pneumonia in supracricoid and supraglottic laryngectomies

et al. 2009

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Summary The goal of this study was to identify host and tumour factors associated with postoperative pneumonia (PP) in a selected population of laryngeal cancer patients, treated by partial laryngectomy in 20 years at our Institution and to assess its potential prognostic impact. Clinical records of 416 consecutive patients were retrospectively reviewed. Tobacco consumption, body mass index (BMI), previous pulmonary disease, age, sex, preoperative blood gas analysis values, tumour stage and type of surgery were tested as potential risk factors for PP. Finally, the prognostic impact of these variables, including PP, in terms of disease-free and actuarial survival by Kaplan-Meier and Cox analyses were evaluated. PP developed in 73 patients (16.8%). We identified two groups of patients: 26 patients experienced an early PP within the first 7-9 days after surgery, whilst 44 experienced an ab ingestis PP following attempts of oral food intake restoration, three patients died for PP related sepsis. At multivariate Cox analysis, age older than 60 years and BMI greater than 30 were statistically associated with early PP; whereas male gender and laryngectomy with neck dissection were statistically related to a higher risk of ab ingestis PP. Interestingly, the occurrence of early PP was a negative independent prognostic factor for 5-years disease-free and actuarial survival (p = 0.049 and p = 0.001, respectively). The occurrence of early-onset pneumonia in laryngeal cancer patients selected for conservative laryngectomies is predictable and associated with poor clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Prognostic role of pneumonia in supracricoid and supraglottic laryngectomies

et al. 2009

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“…8 Differences with deglutition have also been recognized with supracricoid laryngectomy when comparing cricohyoidepiglottopexy and cricohyoidopexy. 9 Others have studied postoperative outcomes. Rademaker et al 10 found that patients with supraglottic laryngectomy returned to oral intake in a median time of 26 days, and patients with extended supraglottic laryngectomy returned to preoperative diets in a median time of 91 to 335 days.…”

Section: Accepted 31 May 2001mentioning

confidence: 99%

Management of swallowing in supraglottic and extended supraglottic laryngectomy patients

et al. 2001

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Certain patients can achieve functional swallowing goals prior to discharge and avoid the cost and surgical placement of a PEG. This group required an additional 2 to 3 days of hospitalization; however, the usual and customary charges for aggressive dysphagia management in this group were exceeded by charges for PEG placement and in-home therapy according to pricing guidelines for the hospital where these patients were treated. Specific patient profiles of those who were unsuccessful relate to extent of surgery, ie, supraglottic + base of tongue (SUPRA + BOT) and supraglottic + vocal fold (SUPRA + VF) resection, and non-compliance. Complicated patients often require longer rehabilitation and may benefit from a PEG at the time of surgery.

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“…There are references to the continuation of severe dysphagia in cases of CHEP where there was no functional dynamic compensation of the epiglottis. 16 There was no statistically significant difference or noteworthy percentage difference between the presence of one or two arytenoids and functional progression of voice and swallowing. Since only one arytenoid was preserved in most cases, similar to other published trials, 17 further studies with larger series, in which two arytenoids are preserved, would be enlightening.…”

Section: Discussionmentioning

confidence: 77%

Estudo funcional da voz e da deglutição na laringectomia supracricóide

Nemr

Carvalho

Köhle³

et al. 2007

Rev. Bras. Otorrinolaringol.

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To identify the grade and evolution of dysphagia and dysphonia in patients undergoing supracricoid laringectomy, and to study the association of these findings with clinical and surgical variables. Method: The study included 22 cases undergoing supracricoid laringectomy at the Head and Neck Surgery and Otolaryngology Department of the Heliopolis Hospital -Brasil, and referred to speech therapy. Dysphagia and dysphonia were correlated with gender, age, stage T (T1, T2, T3, T4), primary site (supraglottis, glottis or subglottis), preservation of one or two arytenoids, reconstructive procedures (cricohyoidopexy or cricohyoido epiglotopexy), time to withdraw the naso-enteral tube, and time to close the tracheostomy. Statistical tests included the Chi-square and/or Fischer's exact test. Results: We observed an association between moderate grade dysphagia and the glottis as the primary site, cricohyoidoepiglotopexy as the type of reconstruction and naso-enteral tube removal within one month after the surgery. There was also an association between severe dysphagia and the supraglottis as the primary site. Dysphagia and dysphonia were associated in the degree of severity; however a larger number of patients had better progression of dysphagia compared to the progression of dysphonia. There was no statistical significance between other associations. Conclusion: Improvement of swallowing is more frequent than improvement of dysphagia. There is an association between moderate dysphagia and the glotttis as primary site, cricohyoidoepiglotopexy and naso-enteral tube removal within one month after surgery.

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Deglutition after supracricoid laryngectomy: Compensatory mechanisms and sequelae

Cited by 41 publications

References 8 publications

Prognostic role of pneumonia in supracricoid and supraglottic laryngectomies

Prognostic role of pneumonia in supracricoid and supraglottic laryngectomies

Management of swallowing in supraglottic and extended supraglottic laryngectomy patients

Estudo funcional da voz e da deglutição na laringectomia supracricóide

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