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Analysis of swallowing after partial frontolateral laryngectomy with epiglottic reconstruction for glottic cancer

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Abstract

The aim of the study was to evaluate swallowing using a reproducible objective methodology and to seek preoperative factors that could influence swallowing outcomes in patients operated on for partial laryngectomy. Twenty-four patients who underwent partial frontolateral laryngectomy with epiglottic reconstruction for T1bN0 or T2N0 glottic carcinoma between 2008 and 2012 were retrospectively evaluated. Using fiberoptic endoscopic and videofluoroscopic evaluation, early (15 days postoperatively) and late (2 months postoperatively) scores were obtained for all patients to quantify their swallowing skills. Eighty-three percent of patients achieved at least partial oral feeding at time of hospital discharge and 87.5 % achieved exclusive oral feeding within 2 months postoperatively. Early score was good or excellent in 50 %, average in 4.2 % and poor in 41.8 %. Regarding late scores, 63 % were classified as having a good or excellent late score, 7 patients (29 %) were classified as “middle result” because their time to recover was longer (i.e. between 1 and 2 months postoperatively), and two patients had a poor late score. Finally, at last follow-up, only one patient was partially fed by gastrostomy (180 days after surgery). T stage (p = 0.04) was the only factor influencing early swallowing outcomes and length of hospital stay was longer for poor scores than for good late results (p = 0.02). Our findings show good outcomes in terms of postoperative swallowing. Objective assessment of deglutition is essential for a better understanding of the mechanisms of postoperative swallowing disorders and for patient selection.

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Conflict of interest

The authors declare no conflict of interest or financial disclosure.

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Authors and Affiliations

  1. Service d’ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France

    Nicolas Fakhry, Justin Michel, Danielle Robert, Aude Lagier, Laure Santini, Eric Moreddu, Patrick Dessi & Antoine Giovanni

  2. Unité d’Anthropologie Bioculturelle, UMR 6578, CNRS-EFS, Faculté de Médecine Nord, Aix-Marseille Université, 51 Boulevard Pierre Dramard, 13916, Marseille, France

    Nicolas Fakhry, Justin Michel, Laure Santini, Eric Moreddu, Laurent Puymerail, Pascal Adalian & Patrick Dessi

  3. LERTIM, EA 3283, Faculté de Médecine, Aix-Marseille Université, 27 Bd Jean Moulin, 13385, Marseille Cedex, France

    Roch Giorgi

  4. Service de Santé Publique et d’Information Médicale, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France

    Roch Giorgi

  5. Laboratoire Parole et Langage (LPL), UMR 7309 CNRS et Aix-Marseille Université, 5 avenue Pasteur, 13100, Aix-en-Provence, France

    Aude Lagier & Antoine Giovanni

Authors
  1. Nicolas Fakhry
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  2. Justin Michel
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  3. Roch Giorgi
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  4. Danielle Robert
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  5. Aude Lagier
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  6. Laure Santini
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  7. Eric Moreddu
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  8. Laurent Puymerail
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  9. Pascal Adalian
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  10. Patrick Dessi
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  11. Antoine Giovanni
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Correspondence to Nicolas Fakhry.

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Fakhry, N., Michel, J., Giorgi, R. et al. Analysis of swallowing after partial frontolateral laryngectomy with epiglottic reconstruction for glottic cancer. Eur Arch Otorhinolaryngol 271, 2013–2020 (2014). https://doi.org/10.1007/s00405-013-2750-3

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  • DOI: https://doi.org/10.1007/s00405-013-2750-3

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