[Use of nasogastric intubation in laryngeal surgery]

This article reviews postoperative feeding in 173 patients after total laryngectomy, pharyngolaryngectomy or functional partial laryngectomy. Nasogastic feeding-tube was used in all patients except those with chordectomy and there was a follow-up of average recovery time of the swallowing function in all operated patients.

We compared effects of feeding, from the 4th postoperative day, via nasogastric tube and orally--without tube on appearance of pharyngocutaneous fistula in laryngectomized patients. Average time of appearance of fistula in total laryngectomies was 9.3 days, in pharyngolaryngectomies 9.7 days. The average length of feeding via nasogastric tube was 11.2 days in the first and 11.7 days in the second group, indicating that fistula appeared at the time of nasogastric tube-feeding, or that the tube did not prevent appearance of fistula. In horizontal supraglottic laryngectomy and subtotal laryngectomy nasogastric tube-feeding is necessary in the first 7 to 10 postoperative days.

When starting peroral feeding it is necessary to take out the tube due to changes it caused on laryngcal mucosa that can prolong the period of swallowing recovery. In vertical partial laryngectomy nasogastric tube is not necessary and peroral feeding can start from the 4th postoperative day. If we compare pharyngolaryngectomy and other kinds of laryngeal operations, the greatest body weight loss occurred in horizontal supraglottic laryngectomy p < 0.05 and subtotal laryngectomy p < 0.05.