Open AccessIncidence and Outcomes of Stricture Formation Post‐laryngectomy
Author(s) -
Sweeny Larissa,
Golden Blake,
Rosenthal Eben L.,
White Hilliary,
Magnuson J. Scott,
Carroll William R.
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811416318a86
Subject(s) - medicine , laryngectomy , surgery , dysphagia , incidence (geometry) , retrospective cohort study , comorbidity , salvage therapy , voice prosthesis , larynx , physics , chemotherapy , optics
Objective Postlaryngectomy stricture formation and dysphagia negatively impact the quality of life and result in nutritional compromise. Understanding risk factors and successful treatment strategies may improve treatment outcomes. Method Patients at a tertiary care center who underwent a total laryngectomy between 2003 and 2009 (n = 263) were evaluated in a retrospective manner. Patient demographics, comorbidities, tobacco and alcohol usage, dietary outcomes, feeding tube dependence, and treatment modalities were assessed. Management strategies and outcomes were evaluated. Results Strictures developed in 19% (n = 49) of 263 laryngectomies and the majority (82%) occurred in the first year. Stricture formation rates were similar for primary (19%) and salvage laryngectomy (18%) patients. Tubed flap reconstruction significantly increased the incidence of stricture formation ( P ≤. 01) in salvage laryngectomy cases. In primary laryngectomy patients, stricture formation was not correlated with flap reconstruction or adjuvant radiation therapy. Patients requiring only a single dilation had better dietary outcomes (semi‐solid) compared to patients requiring serial dilations. Stricture formation was associated with improved overall disease free survival ( P ≤. 01) and recurrence rates ( P =. 06). Conclusion Stricture formation occurs equally in salvage and primary laryngectomies and is associated with an improved disease‐free survival.