Abstract
Early decannulation, performed within the first ten days after supracricoid partial laryngectomy, can result in a more rapid recovery of swallowing function with a semisolid bolus in the short term, about 30 days. We selected 20 patients with squamous cell carcinoma of larynx, who underwent supracricoid laryngectomies: 10 cricohyoidopexy (CHP) and 10 cricohyoidoepiglottopexy (CHEP). Staging was pT2 (10 pts), and pT3 (10 pts). Fiberoptic endoscopic evaluation of swallowing was used to assess postoperative swallowing function after a mean of 12 and 22 days from surgery. A modified PAS score (penetration-aspiration scale) was assigned for subtotal laryngectomies. Decannulation occurred after 6.7 ± 2.1 days. Univariate analysis showed that the type of surgery (CHP or CHEP), pT, resection of one arytenoid, and decannulation time are significantly associated with the 12-day PAS score. The 22-day PAS score is significantly associated with only 3 variables: type of surgery, pT, and resection of one arytenoid. From the data presented, the factors that most delay an effective recovery of swallowing are T3 and the resection of one arytenoid. Early decannulation has been shown statistically to improve PAS score in the short term, but not in the long term.
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References
Schindler A, Pizzorni N, Mozzanica F, Fantini M, Ginocchio D, Bertolin A, Crosetti E, Succo G (2016) Functional outcomes after supracricoid laryngectomy: What do we not know and what do we need to know? Eur Arch Otorhinolaryngol 273(11):3459–3475. https://doi.org/10.1007/s00405-015-3822-3
Alicandri-Ciufelli M, Piccinini A, Grammatica A, Chiesi A, Bergamini G, Luppi MP, Nizzoli F, Ghidini A, Tassi S, Presutti L (2013) Voice and swallowing after partial laryngectomy: factors influencing outcome. Head Neck 35(2):214–219. https://doi.org/10.1002/hed.22946
Jun-Ook P, Young-Hoon J, Kwang-Jae C, Nam-Gyun K, Min-Sik K (2011) Functional and oncologic results of extended supracricoid partial laryngectomy. Arch Otolaryngol Head Neck Surg 137(11):1124–1129. https://doi.org/10.1001/archoto.2011.182
Rizzotto G, Crosetti E, Lucioni M, Succo G (2012) Subtotal laryngectomy: outcomes of 469 patients and proposal of a comprehensive and simplified classification of surgical procedures. Eur Arch Otorhinolaryngol 269:1635–1646
Schindler A, Biondi S, Farneti D, Ruoppolo G, Spadola Bisetti M, Travalca CB (2009) La valutazione fibroendoscopica della deglutizione. Position statement del GISD (Gruppo Italiano Studio Disfagia). Argom Acta Otorhinolaryngol Ital 3:6–9
Simonelli M, Ruoppolo G, de Vincentiis M, Di Mario M, Calcagno P, Vitiello C, Manciocco V, Pagliuca G, Gallo A (2010) Swallowing ability and chronic aspiration after supracricoid partial laryngectomy. Otolaryngol Head Neck Surg 142:873–878
Luna-Ortiz K, Núñz-Valencia ER, Tamez-Velarde M, Granados-Garcia M (2004) Quality of life and functional evaluation after supracricoid partial laryngectomy with cricohyoidoepiglottopexy in Mexican patients. J Laryngol Otol 118(4):284–288. https://doi.org/10.1258/002221504323012030
Lewin JS, Hutcheson KA, Barringer DA, May AH, Roberts DB, Holsinger FC (2008) Diaz EM Jr Functional analysis of swallowing outcomes after supracricoid partial laryngectomy. Head Neck 30(5):559–566. https://doi.org/10.1002/hed.20738
Di Santo D, Bondi S, Giordano L, Galli A, Tulli M, Ramella B, Mario Bussi M (2019) Long-term swallowing function, pulmonary complications, and quality of life after supracricoid laryngectomy. Otolaryngol Head Neck Surg 161(2):307–314. https://doi.org/10.1177/0194599819835189
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Grasso, M., Fusconi, M., De Luca, P. et al. Partial Horizontal Supracricoid Laryngectomy: Which Factors Impact on Post-decannulation Swallowing Outcomes? A Prospective Single-Center Experience. Indian J Otolaryngol Head Neck Surg 75, 1917–1922 (2023). https://doi.org/10.1007/s12070-023-03790-6
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DOI: https://doi.org/10.1007/s12070-023-03790-6