Analysis of Swallowing Function after Supracricoid Laryngectomy with Cricohyoidopexy

• Published in: Otolaryngology-head and neck surgery 2012-03, Vol.146 (3), p.412-418
• Main Authors: Topaloğlu, İlhan, Köprücü, Gayem, Bal, Muhlis
• Format: Article
• Language: English
• Subjects: Analysis of Variance; Arytenoid Cartilage - pathology; Arytenoid Cartilage - surgery; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Cohort Studies; cricohyoidopexy; Cricoid Cartilage - pathology; Cricoid Cartilage - surgery; Deglutition - physiology; Deglutition - radiation effects; Deglutition Disorders - epidemiology; Deglutition Disorders - etiology; Deglutition Disorders - physiopathology; Female; fiber‐optic evaluation; Follow-Up Studies; Humans; Laryngeal Neoplasms - mortality; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - radiotherapy; Laryngeal Neoplasms - surgery; Laryngectomy - adverse effects; Laryngectomy - methods; Laryngoscopy - methods; Male; Monitoring, Physiologic - methods; Neoplasm Invasiveness - pathology; Neoplasm Staging; quality of life; Reference Values; Retrospective Studies; Risk Assessment; Statistics, Nonparametric; supracricoid laryngectomy; Survival Rate; swallowing; Treatment Outcome
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1177/0194599811428582

Objective. To evaluate the swallowing function after supracricoid laryngectomy with cricohyoidopexy, focusing on the effects of arytenoid cartilage resection and radiation therapy. Study Design. Case series with chart review. Setting. Tertiary medical center. Subjects and Methods. Thirty supracricoid laryngectomy-cricohyoidopexy patients, at least 1 year after treatment, were retrospectively analyzed. Fiber-optic endoscopic evaluation of swallowing was performed for each patient. Three blinded judges evaluated the video recordings based on 3 parameters. The M. D. Anderson Dysphagia Inventory was completed by each patient for assessment of disease-specific quality of life. Results. All patients were decannulated at an average of 23.6 days. Nasogastric feeding tubes were removed at an average of 27.3 days, and all patients could eat orally. Fiber-optic endoscopic evaluation of swallowing showed that patients with total resection of 1 arytenoid had more bolus retention than patients with both arytenoids preserved (P = .008). Compared with patients who did not receive radiotherapy, patients who did receive radiotherapy exhibited increased retention (P = .021) and aspiration (P = .007). The M. D. Anderson Dysphagia Inventory results revealed no differences in quality of life according to the level of arytenoid resection or the administration of radiotherapy. Conclusion. The functional evaluation of swallowing after supracricoid laryngectomy—cricohyoidopexy showed satisfactory results. Patients with total resection of 1 arytenoid had significantly higher bolus retention, and those who received radiotherapy had significantly increased retention and aspiration.