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European Archives of Oto-Rhino-Laryngology

, Volume 273, Issue 11, pp 3459–3475 | Cite as

Functional outcomes after supracricoid laryngectomy: what do we not know and what do we need to know?

  • Antonio SchindlerEmail author
  • Nicole Pizzorni
  • Francesco Mozzanica
  • Marco Fantini
  • Daniela Ginocchio
  • Andy Bertolin
  • Erika Crosetti
  • Giovanni Succo
Review Article

Abstract

Supracricoid laryngectomies (SCLs) are conservative organ-sparing surgical techniques for the treatment of selected T2–T4 laryngeal carcinomas. Although these procedures allow preserving the larynx and its functions, in several countries SCLs are not adopted in oncological protocols. One of the possible reasons to account for this choice is the complexity of post-surgical in-hospital management and the variability in functional results. The aim of this review is to analyse the literature on functional results after SCLs as knowledge on functional results will help in focusing on what is needed in the future to reach more standardized post-surgical procedures and homogeneous outcomes. The analysis of the length of hospital stay, feeding-tube removal time and time to eventual tracheotomy decannulation showed a marked variability across authors and centres. Several factors may come into play, including health-system organizations in different countries. In most studies in-depth description of the criteria applied for discharge, tracheotomy tube removal and commencement of oral feeding were not reported. Moreover, the review on swallowing functional outcomes showed marked variability, as well as a lack of consensus on how to assess swallowing after SCLs. The analysis of voice functional outcomes also revealed a marked variability; surprisingly, the tools applied in the assessments were very often not adequate for substitution voice. Literature review showed that voice- and swallowing-related quality of life are often satisfactory but the variability among centres is still too large. Therefore, there is a need for clearer clinical recommendations on early post-surgical management, tracheal-cannula and feeding-tube removal criteria, voice- and swallowing-assessment protocol, rehabilitation need and timing.

Keywords

Laryngeal cancer Supracricoid laryngectomy Dysphagia Dysphonia Quality of life Outcome Functional results 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Antonio Schindler
    • 1
    Email author
  • Nicole Pizzorni
    • 1
  • Francesco Mozzanica
    • 1
  • Marco Fantini
    • 2
  • Daniela Ginocchio
    • 3
  • Andy Bertolin
    • 4
  • Erika Crosetti
    • 5
  • Giovanni Succo
    • 2
  1. 1.Department of Biomedical and Clinical Sciences, Phoniatric Unit L. Sacco Hospital, University of MilanMilanItaly
  2. 2.Department of Otorhinolaryngology, Ospedale San Luigi GonzagaUniversity of TurinTurinItaly
  3. 3.Audiology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS “Ca’ Granda”, Ospedal Maggiore PoliclinicoUniversity of MilanMilanItaly
  4. 4.Department of OtorhinolaryngologyOspedale Civile of Vittorio VenetoBellunoItaly
  5. 5.Department of OtorhinolaryngologyOspedale MartiniTurinItaly

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