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Functional results of pharyngo-laryngectomy and total laryngectomy: a comparison

Published online by Cambridge University Press:  26 August 2011

C Gadepalli ,
C de Casso ,
S Silva ,
S Loughran  and
J J Homer
C Gadepalli
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Manchester Academic Health Science Centre, Manchester Royal Infirmary, University of Manchester, UK
C de Casso
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Manchester Academic Health Science Centre, Manchester Royal Infirmary, University of Manchester, UK
S Silva
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Manchester Academic Health Science Centre, Manchester Royal Infirmary, University of Manchester, UK
S Loughran
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Manchester Academic Health Science Centre, Manchester Royal Infirmary, University of Manchester, UK
J J Homer*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Manchester Academic Health Science Centre, Manchester Royal Infirmary, University of Manchester, UK School of Cancer and Enabling Sciences, University of Manchester, UK
*
Address for correspondence: Mr Jarrod J Homer, Consultant Head and Neck Surgeon/Otolaryngologist, Manchester Royal Infirmary, Oxford Road, Manchester M13 9DL, UK Fax: +44 (0)161 448 0310 E-mail: [email protected]
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Abstract

Objective:

To compare the key functional results (regarding swallowing and voice rehabilitation) in patients treated by pharyngo-laryngectomy with flap reconstruction, versus standard, wide-field, total laryngectomy.

Method:

We studied 97 patients who had undergone total laryngectomy and pharyngo-laryngectomy with flap reconstruction. The main outcome measures were swallowing (i.e. solid food, soft diet, fluid or enteral feeding) and fluent voice development.

Results:

There were 79 men and 18 women, with follow up of one to 19 years. Voice (p = 0.037) and swallowing (p = 0.041) results were significantly worse after circumferential pharyngo-laryngectomy than after non-circumferential pharyngo-laryngectomy. There was no significant difference in voice (p = 0.23) or swallowing (p = 0.655) results, comparing total laryngectomy and non-circumferential pharyngo-laryngectomy. The presence of a post-operative fistula significantly influenced voice (p = 0.001) and swallowing (p = 0.009) outcomes.

Conclusion:

The additional measures involved in pharyngo-laryngectomy do not confer any functional disadvantage, compared with total laryngectomy, but only if the procedure is non-circumferential. Functional results of circumferential pharyngo-laryngectomy are worse than those of both non-circumferential pharyngo-laryngectomy and total laryngectomy. If oncologically possible and safe, it is better to keep a pharyngo-laryngectomy non-circumferential.

Keywords

VoiceSwallowingLaryngectomyPharyngectomyCarcinoma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 1 , January 2012 , pp. 52 - 57
Copyright
Copyright © JLO (1984) Limited 2011

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Footnotes

Presented at the ENT-UK Annual Conference, 10 September 2010, Coventry, UK

References

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