How the operated larynx ages.

Area of Science:

• Otolaryngology
• Geriatric Medicine
• Surgical Oncology

Background:

• Open partial laryngectomy (HOPL) is a common surgical procedure for laryngeal cancer.
• Post-operative laryngeal function often deteriorates over time, impacting swallowing and voice.
• Long-term functional outcomes after HOPL in elderly patients require further investigation.

Purpose of the Study:

• To evaluate laryngeal functional outcomes at least 10 years after open partial laryngectomy (HOPL).
• To assess the incidence of aspiration pneumonia (AP) and its association with dysphagia.
• To analyze the impact of surgical intervention type and extent on dysphagia, dysphonia, and voice handicap.

Main Methods:

• Retrospective cohort study of 80 elderly patients who underwent HOPL.
• Objective and subjective assessments of laryngeal function, including swallowing and voice.
• Analysis of aspiration pneumonia (AP) incidence and its correlation with dysphagia severity.

Main Results:

• Eight patients (10%) experienced aspiration pneumonia (AP), with four having recurrent episodes.
• A significant association was found between AP and the severity of dysphagia (p < 0.001).
• Dysphagia was more pronounced than in age-matched controls but less than anticipated; voice handicap correlated with glottic resection extent.

Conclusions:

• Laryngeal function remains impaired after HOPL, but does not significantly affect long-term quality of life.
• Aspiration pneumonia (AP) incidence is higher in the early post-operative period and diminishes over subsequent years.
• The type and extent of surgical intervention significantly influence dysphagia and voice outcomes post-HOPL.