Affiliation:
1. Department of Otolaryngology–Head and Neck Surgery University of Kansas School of Medicine Kansas City Kansas USA
Abstract
AbstractObjectiveAdvanced‐stage laryngeal squamous cell carcinoma is treated with primary surgery or chemoradiation. We aim to determine if there are differences in postoperative functional oral intake in primary (PL) versus salvage laryngectomees (SL).Study DesignRetrospective cohort study.SettingPatients who underwent laryngectomy between 2011 and 2021.MethodsWe examined demographic, diagnostic, treatment, and swallow function data pre‐ and postoperatively. A follow‐up survey was distributed to assess current swallow status.ResultsOne hundred twenty‐five patients were included. Preoperatively, 68.8% of patients reported dysphagia. Median functional oral intake score (FOIS) was 4.0 [interquartile range, IQR: 1.0‐6.75]. The SL group had lower preop FOIS [2.0; IQR: 1.0‐4.75] that did not reach significance compared to the PL group [4.5; IQR: 1.0‐7.0] (P = .052). 73.4% of patients had a feeding tube. The PL group was more likely to have the tube removed [odds ratio, OR: 2.4; confidence interval, CI: 1.0‐5.7]. The SL group was more likely to require feeding tube placement more than 6 months postop [OR: 6.9; CI: 1.65‐32.6]. SL FOIS scores improved by 3 months postop to 5 (SL ΔFOIS = 3, P = .0150). PL scores improved to 7 [PL ΔFOIS = 2, P = .0005] at 12 to 15 months. Sixty‐nine patients were contacted for a follow‐up survey and 16 completed this survey. 30.4% patients reported dietary restrictions (mean 4.4 years postop).ConclusionPatients undergoing SL appear to obtain similar swallow outcomes compared to PL at 3 to 6 months postlaryngectomy, but plateau. The PL group continues to improve up to 1 year postoperatively. Fifty percent of patients report on‐going dysphagia after 5 years.