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Functional analysis of swallowing outcomes after supracricoid partial laryngectomy
Author(s) -
Lewin Jan S.,
Hutcheson Katherine A.,
Barringer Denise A.,
May Annette H.,
Roberts Dianna B.,
Holsinger F. Christopher,
Diaz Eduardo M.
Publication year - 2008
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20738
Subject(s) - swallowing , medicine , dysphagia , aspiration pneumonia , airway , surgery , tongue , feeding tube , laryngectomy , pneumonia , anesthesia , larynx , pathology
Background. In this study, we analyzed swallowing recovery after supracricoid partial laryngectomy (SCPL). Methods. We retrospectively reviewed 27 patients treated with SCPL (September 1997 to March 2005). We evaluated recovery course, nutritional outcomes, and swallowing using objective analysis. Modified barium swallow (MBS) study results identified swallowing physiology and therapeutic effectiveness. Results. Average length of hospitalization was 7.7 ± 9.2 days; time to decannulation was 5.3 ± 8.2 weeks. The most common complications included pneumonia and subcutaneous emphysema (26%). Twenty‐two patients had MBS studies, in which initially, all patients aspirated due to neoglottic incompetency, and impaired base of tongue and laryngeal movements. Although aspiration rates did not change significantly over time, use of appropriately selected swallowing strategies effectively protected the airway ( p = .0365). Ultimately, 81% of patients returned to complete oral intake with median tube removal at 9.4 weeks. Conclusion. SCPL produces severe dysphagia initially. Our findings suggest that objective swallowing assessment is important for return to oral nutrition after SCPL. © 2007 Wiley Periodicals, Inc. Head Neck, 2008