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Prospective analysis of functional swallowing outcome after resection of T2 glottic carcinoma using transoral laser surgery and external vertical hemilaryngectomy

  • Laryngology
  • Published:
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Abstract

56 patients affected by T2 glottic carcinoma were treated in two institutes using transoral laser microsurgery (TLM) in 40 cases and vertical hemilaryngectomy in 16 cases between September 2012 and September 2015. In the TLM group, different subtypes of type V cordectomy were used according to the extent of tumor. In the vertical hemilaryngectomy group, classical operation was used in most of the cases and the resection was extended in few cases. Analysis of post-operative swallowing function was done using videofluoroscopy (VFS), functional endoscopic evaluation of swallowing, and subjectively using MD Anderson dysphagia inventory. Objective evaluation of swallowing has been made by obtaining different measures from VFS (pharyngeal transit time, pharyngeal constriction ratio, and hyoid displacement for example). Analysis also included the need and duration of tracheostomy and nasogastric tube, ICU admission, and hospitalization time. Statistical analysis was performed with the Mann–Whitney U and Pearson Chi-square tests. Comparison of incidence of aspiration and swallowing outcome showed significantly better results in the laser group than in the vertical group (p < 0.001). The duration of ICU, tracheostomy, nasogastric tube, and hospital stay was also significantly shorter in the laser group (p < 0.001). This study shows that TLM had significantly better overall postoperative outcome than vertical hemilaryngectomy. It was associated with significantly shorter hospital stay and less need for tracheostomy, nasogastric tube, and ICU admission). Measures obtained from VFS are useful for detection and follow-up of postoperative aspiration, because it is a definitive technique for anatomical and physiological study of swallowing.

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Authors and Affiliations

  1. Otorhinolaryngology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Hani Osama Nasef & Hossam Thabet

  2. Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Brescia, Brescia, Italy

    Cesare Piazza, Francesca Del Bon & Piero Nicolai

  3. Department of Radiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Mohamed Eid

  4. Department of Phoniatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Manal El Banna

Authors
  1. Hani Osama Nasef
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  2. Hossam Thabet
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  4. Francesca Del Bon
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  7. Piero Nicolai
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Correspondence to Hani Osama Nasef.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Nasef, H.O., Thabet, H., Piazza, C. et al. Prospective analysis of functional swallowing outcome after resection of T2 glottic carcinoma using transoral laser surgery and external vertical hemilaryngectomy. Eur Arch Otorhinolaryngol 273, 2133–2140 (2016). https://doi.org/10.1007/s00405-016-4065-7

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  • DOI: https://doi.org/10.1007/s00405-016-4065-7

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