Laryngeal Framework Surgery in the Irradiated Neck: A Retrospective Matched Cohort Study

Background: Laryngeal framework surgery (LFS) remains a cornerstone treatment in the management of glottic insufficiency. Traditionally, a history of radiation to the neck has been considered a relative contraindication to LFS. Methods: A retrospective matched cohort study was performed to study LFS...

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Bibliographic Details
Published in:Annals of otology, rhinology & laryngology rhinology & laryngology, 2016-10, Vol.125 (10), p.823-828
Main Authors: Kubik, Mark, Rosen, Clark
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Case-Control Studies
Cohort Studies
Dysphonia - surgery
Female
Glottis - surgery
Head and Neck Neoplasms - therapy
Humans
Laryngoplasty
Male
Middle Aged
Otorhinolaryngologic Surgical Procedures
Radiotherapy
Retrospective Studies
Treatment Outcome
Vocal Cord Paralysis - surgery
Voice Quality
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Summary:Background: Laryngeal framework surgery (LFS) remains a cornerstone treatment in the management of glottic insufficiency. Traditionally, a history of radiation to the neck has been considered a relative contraindication to LFS. Methods: A retrospective matched cohort study was performed to study LFS outcomes in patients with and without a history of radiation. Variables studied included radiation specifics, surgical time, operative difficulty, complications, need for revision surgery, and Voice Handicap Index-10 (VHI-10) scores. Results: A total of 298 patients were studied. Fourteen patients with a history of neck irradiation were matched with 14 nonirradiated controls. No complications were encountered in the nonirradiated cohort. In the irradiated cohort, there were 2 minor wound complications and 1 admission for stridor treated medically. No cases of implant extrusion were observed. The VHI-10 scores were improved in both cohorts relative to preoperative baseline (P = .001). Posttreatment VHI-10 scores were better in the nonirradiated cohort (P = .03). There was no difference between cohorts with respect to complication rates, surgical time, surgical difficulty, length of stay, use of a surgical drain, or need for revision surgery. Conclusion: Laryngeal framework surgery is safe and associated with improved voice outcomes in patients with a history of neck irradiation.
ISSN:0003-4894
1943-572X
DOI:10.1177/0003489416656203