Factors in Successful Deglutition following Supraglottic Laryngeal Surgery

Flores, Toribio C.; Wood, Benjamin G.; Koegel, Lawrence; Levine, Howard L.; Tucker, Harvey M.

doi:10.1177/000348948209100608

Cited by 67 publications

(22 citation statements)

References 9 publications

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“…As in previous studies [5][6][7][8][9][10][11][12][13][14], the mean hospital stay of 6.4 days in the present study was shorter than that necessary for most forms of open surgery [23,24]. However, the hospital stay was longer for the second cancer in the two patients who had synchronous cancer.…”

Section: Discussionsupporting

confidence: 73%

Transoral robotic surgery for head and neck carcinomas

Hans

Badoual

Gorphe

et al. 2011

Eur Arch Otorhinolaryngol

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The objective of this study was prospectively to assess the feasibility and safety of transoral robotic surgery (TORS) in head and neck carcinomas and to report our learning curve and 2-year outcomes. Patients with oropharyngeal, hypopharyngeal and laryngeal tumors treated with TORS were prospectively included. We evaluated: the feasibility of TORS, robotic set-up time, transoral robotic surgery time, blood loss, surgical margins, tracheotomy, feeding tube, time to oral feeding and surgery-related complications. Twenty-three patients were treated for 25 carcinomas. Twenty-two patients underwent successful robotic resection for 24 carcinomas (96%). One patient required conversion to open surgery due to massive bleeding. The mean robotic set-up time was 25 min (range: 15-100 min) and mean TORS operating time was 70 min (range: 20-150 min). Positive margin of resection was observed in one patient (classified pT3) out of the 24 cancers and was managed by postoperative chemoradiation. No tracheotomy was performed. Three patients required prolonged intubation for a mean of 22 h. Two patients required a temporary gastrostomy (for 2 and 3.5 months, respectively). All other patients resumed oral feeding between the first and third postoperative day. The mean hospital stay was 6.4 days (range: 4-19 days). No postoperative complication occurred. Mean follow-up was 20 months (median: 19, range: 14-26). No death and no case of local or metastatic failure were observed. TORS is feasible and safe for the resection of selected head and neck carcinomas. The occurrence of intraoperative bleeding emphasizes the need for surgeons to be skilled in both transoral and open approaches.

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Section: Discussionsupporting

confidence: 73%

Transoral robotic surgery for head and neck carcinomas

Hans

Badoual

Gorphe

et al. 2011

Eur Arch Otorhinolaryngol

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“…The horizontal supraglottic laryngectomy, first described by Alonso in the 1950s [1,2] and later modified by other authors [6,24,26], showed oncological results comparable to total laryngectomy [12,13]. In these cases, however, protracted post-operative phases of rehabilitation of respiration and deglutition have to be taken into account [8]. In most cases one cannot avoid tracheotomy and as a complication, pharyngocutaneous fistulae may occur [10,41].…”

Section: Introductionmentioning

confidence: 99%

Swallowing function after endoscopic resection of supraglottic carcinoma with the carbon dioxide laser

Oeken¹,

Hänsch²,

Thiel³

et al. 2001

European Archives of Oto-Rhino-Laryngology

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From April 1998 to May 2000, 14 patients with supraglottic cancer underwent transoral laser surgery (T-stage T1-2: 11 patients, T3: 3 patients). In three patients, an epiglottectomy or hemi-epiglottectomy was performed. In 11 patients, further structures (false cords, the valleculae and the base of the tongue and/or parts of the arytenoid cartilage) had to be resected. Thirteen patients had to undergo neck dissection and post-operative irradiation. Tracheostomy was carried out prophylactically in two cases. Every patient received a nasogastric tube perioperatively. One week after surgery, an evaluation of dysphagia was performed by video endoscopy (VEED). Aspiration was the main problem; in no case did dysphagia occur. The aspiration was graded according to videolaryngoscopical classification. Four patients had an occasional and ten patients a permanent aspiration after surgery. According to this assessment, an individual deglutition therapy management was established. Ten patients with permanent aspiration received a temporary percutaneous endoscopic gastrostomy (PEG) and were integrated in a rehabilitation programme (stimulation of the swallowing reflex, training of compensatory swallowing manoeuvres, dietary regime). Due to this training programme, the PEG could be removed in eight patients after 2-9 months. No patient needed a laryngectomy or a tracheostomy due to aspiration. There were no cases of aspiration-associated pneumonia. To obtain satisfying functional results after transoral laser surgery of supraglottic cancers with resection of the epiglottis, post-operative deglutition management, consisting of video endoscopy, a training programme and often a PEG, is necessary.

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“…22 An entity called pseudoepiglottis which is a fold of mucous membrane and sometimes scar tissue coming from the lateral pharyngeal wall into the base of the tongue sometimes impairs swallowing. 23,24 The pseudoepiglottis can be diagnosed on lateral X-ray soft tissue neck but mirror examination misses it as it rests hidden below the base of the tongue.…”

Section: Ijoplmentioning

confidence: 99%

Untreated Cleft Palate a Unique Surgical Contraindication in Carcinoma of the Pyriform Fossa

Naik¹

2012

International Journal of Phonosurgery &Amp; Laryngology

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Background/objectives: Swallowing problems following total laryngectomy are significantly lesser compared to other partial laryngectomies as a permanent seperation between the trachea and esophagus is seen in the earlier. Sometimes, the patient complains of difficulty in propelling bolus through the oral cavity and pharynx as a result of the loss of hyoid bone, which is the anchor for the tongue. The increased pressure in the narrowed pharyngoesophageal segment following laryngectomy requires the tongue to move with greater force.

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Factors in Successful Deglutition following Supraglottic Laryngeal Surgery

Cited by 67 publications

References 9 publications

Transoral robotic surgery for head and neck carcinomas

Transoral robotic surgery for head and neck carcinomas

Swallowing function after endoscopic resection of supraglottic carcinoma with the carbon dioxide laser

Untreated Cleft Palate a Unique Surgical Contraindication in Carcinoma of the Pyriform Fossa

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