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Predictable swallowing function after open horizontal supraglottic partial laryngectomy.

Christine Breunig1, Philipp Benter2, Rainer O Seidl1

  • 1Department of Otolaryngology at UKB, Hospital of the University of Berlin, Charité Medical School, Berlin, Germany.

Auris, Nasus, Larynx
|February 9, 2016
PubMed
Summary
This summary is machine-generated.

Tongue base tumor extension significantly impacts swallowing recovery after supraglottic partial laryngectomy. Larger tongue base infiltration areas predict longer nasogastric tube dependence, aiding surgical planning for better patient outcomes.

Keywords:
DysphagiaHorizontal supraglottic partial laryngectomySpeech cannulaSwallow functionTracheotomy tube

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Area of Science:

  • Otolaryngology
  • Surgical Oncology
  • Swallowing Disorders

Background:

  • Horizontal supraglottic partial laryngectomy can lead to dysphagia due to impaired laryngeal entrance closure.
  • Tumor extension into the tongue base increases the risk of swallowing difficulties post-surgery.
  • Predictive factors for postoperative swallow function after this procedure are not well-established.

Purpose of the Study:

  • To investigate the impact of tongue base tumor extension on swallow function recovery after horizontal supraglottic partial laryngectomy.
  • To determine if radiologically measured tumor dimensions can predict postoperative swallowing outcomes.
  • To identify risk factors for impaired swallow function in these patients.

Main Methods:

  • Retrospective study of patients undergoing open horizontal supraglottic partial laryngectomy for tongue base oropharyngeal cancer or supraglottic laryngeal cancer with tongue base infiltration.
  • Clinicopathological data and CT scan measurements of tongue base tumor dimensions were collected.
  • Swallow function was assessed using Fiberoptic Endoscopic Evaluation of Swallowing, time to nasogastric tube removal, and tracheostomy tube status.

Main Results:

  • Twenty-six patients (median age 59 years) were included.
  • Tongue base infiltration width, height, and area were significantly associated with the duration of nasogastric tube dependence (p<0.0001 for area).
  • Patients with a tongue base infiltration area <6.20cm² had nasogastric tubes removed after a median of 4 days, versus 22 days for those with areas ≥6.20cm².

Conclusions:

  • Postoperative swallow function is dependent on the extent of tongue base tumor invasion.
  • Tongue base infiltration area is a valuable tool for predicting postoperative swallow function and aiding surgical planning.
  • Consideration of alternative primary therapies like chemoradiation is recommended for cases with foreseeable permanent dysphagia or tracheotomy needs.