Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T03:52:45.089Z Has data issue: false hasContentIssue false
  • English
  • Français

Early oral feeding following total laryngectomy

Published online by Cambridge University Press:  23 May 2008

J Aswani ,
M Thandar ,
J Otiti  and
J Fagan
J Aswani
Affiliation:
Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa
M Thandar
Affiliation:
Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa
J Otiti
Affiliation:
Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa
J Fagan*
Affiliation:
Division of Otolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa
*
Address for correspondence: Professor J J Fagan, Division of Otolaryngology, University of Cape Town, H-53 OMB, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa. E-mail: [email protected] Fax: +27 (0) 21 448 8865
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To determine whether, in a developing world context, early oral feeding after laryngectomy is safe, cost-effective and appropriate.

Study design:

A prospective study of early oral feeding after laryngectomy, compared with retrospective, historical delayed feeding controls.

Method:

Forty patients underwent total laryngectomy for advanced carcinoma of the larynx with or without hypopharyngeal involvement, not requiring tongue base resection or myocutaneous flaps, and were commenced on oral feeding on the second post-operative day. Thirty-nine laryngectomy patients previously managed in the same unit who had received conventional, delayed oral feeding served as controls.

Results:

Pharyngocutaneous fistulae developed in 20 per cent of the early feeding patients, compared with 15.4 per cent of the delayed oral feeding controls (p = 0.592). For patients who did not develop fistulae, hospitalisation was shorter in the early oral feeding group (p = 0.007).

Conclusion:

Early oral feeding for laryngectomy patients is recommended, both in developed and developing countries.

Keywords

LaryngectomyFeedingComplicationsNutrition
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 3 , March 2009 , pp. 333 - 338
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Kishore, CP, Suja, S, Naveen, KD, Sampath, CP, Satish, C. Early oral feeds in laryngectomized patients. Ann Otol Rhinol Laryngol 2006;115:433–8Google Scholar
2 Seven, H, Asli, BC, Suat, T. A randomized controlled trial of early oral feeding in laryngectomized patients. Laryngoscope 2003;113:1076–9CrossRefGoogle ScholarPubMed
3 Boyce, SE, Meyers, AD. Oral feeding after total laryngectomy. Head Neck 1989;11:269–73CrossRefGoogle ScholarPubMed
4 Genden, E, Ferlito, A, Rinaldo, A, Silver, CE, Fagan, JJ, Suárez, C et al. Recent changes in the treatment of patients with advanced laryngeal cancer. Head Neck 2008;30:103–10CrossRefGoogle ScholarPubMed
5 Applebaum, EL, Levine, HL. Pharyngeal reconstruction after laryngectomy. Laryngoscope 1977;87:1844–90CrossRefGoogle ScholarPubMed
6 Cantrell, RW. Pharyngeal fistula: prevention and treatment. Laryngoscope 1978;88:1204–8CrossRefGoogle ScholarPubMed
7 Krouse, JH, Metson, R. Barium swallow is a predictor of salivary fistula following laryngectomy. Otolaryngol Head Neck Surg 1992;106:254–7CrossRefGoogle ScholarPubMed
8 Rodriguez-Ceuvas, S, Labastida, S, Gutierrez, F, Granados, F. Oral feeding after total laryngectomy for endolaryngeal cancer. Eur Arch Otolaryngol 1995;252:130–2Google Scholar
9 Kent, SE, Liu, KC, Das Gupta, AR. Post-laryngectomy pharyngocutaneous fistulae. J Laryngol Otol 1985;99:1005–8CrossRefGoogle Scholar
10 Ikiz, AU, Uca, M, Guneri, EA, Erdag, TK, Sutay, S. Pharyngocutaneous fistula and total laryngectomy: possible predisposing factors, with emphasis on pharyngeal myotomy. J Laryngol Otol 2000;14:768–71CrossRefGoogle Scholar
11 Udaipurwala, IH, Iqbal, K, Jalisi, M. Pharyngocutaneous fistula following laryngectomy. J Pak Med Assoc 1995;45:130–2Google ScholarPubMed
12 Aprigliano, F. Use of the nasogastric tube after total laryngectomy: is it truly necessary? Ann Otol Rhinol Laryngol 1990;99:513–14CrossRefGoogle ScholarPubMed
13 Papazoglou, G, Doundoulakis, G, Terzakis, G, Dokianakis, G. Pharyngocutaneous fistula after total laryngectomy: incidence, cause and treatment. Ann Otol Rhinol Laryngol 1994;103:801–5CrossRefGoogle Scholar
14 Song, J, Jing, S, Shi, H. The clinical observation of early oral feeding following total laryngectomy. Lin Chuang Erh Pi Yen Hou Ko Tsa Chih 2003;17:527–8 [in Chinese, Pubmed abstract in English]Google ScholarPubMed
15 Volling, P, Singelmann, H, Ebeling, O. Incidence of salivary fistulas in relation to timing of oral nutrition after laryngectomy. HNO 2001;49:276–82 [in German, Pubmed abstract in English]CrossRefGoogle ScholarPubMed
16 Medina, JE, Khalif, A. Early oral feeding following total laryngectomy. Laryngoscope 2001;111:368–72CrossRefGoogle ScholarPubMed
17 Fradis, M, Podoshin, L, David, JB. Post-laryngectomy pharyngocutaneous fistula – a still unresolved problem. J Laryngol Otol 1995;109:221–4CrossRefGoogle ScholarPubMed
18 Saydam, L, Kalcioglu, T, Kizilay, A. Early oral feeding following total laryngectomy. Ann J Otolaryngol 2002;23:277–81CrossRefGoogle ScholarPubMed
19 Soylu, L, Kiroglu, M, Aydogan, B, Cetik, F, Kiroglu, F, Akçali, C et al. Pharyngocutaneous fistula following laryngectomy. Head Neck 1998;20:25–53.0.CO;2-5>CrossRefGoogle ScholarPubMed
20 Markou, KD, Vlachtsis, KC, Nikolaou, AC, Petridis, DG, Kouloulas, AI, Dahiilidis, IC. Incidence and predisposing factors of pharyngocutaneous fistula after total laryngectomy. Is there a relationship with tumour recurrence? Eur Arch Otorhinolaryngol 2004;261:61–7CrossRefGoogle Scholar
21 Natvig, K, Boysen, M, Tausj, UJ. Fistula in patients treated with irradiation. J Laryngol Otol 1993;107:1136–9CrossRefGoogle ScholarPubMed
22 Lundgren, J, Olofsson, J. Pharyngocutaneous fistulae following total laryngectomy. Clin Otolaryngol 1979;4:13–23CrossRefGoogle ScholarPubMed
23 Virtaniemi, JA, Kumpulainen, EJ, Hirvikoski, PP, Johansson, RT, Kosma, VM. The incidence and etiology of postlaryngectomy pharyngocutaneous fistulae. Head Neck 2001;23:29–333.0.CO;2-P>CrossRefGoogle ScholarPubMed
24 Mendelsohn, MS, Bridger, GP. Pharyngocutaneous fistulae following laryngectomy. Aust N Z J Surg 1985;55:17–19CrossRefGoogle ScholarPubMed
25 Chee, N, Siow, JK. Pharyngocutaneous fistula after total laryngectomy – incidence, predisposing factors and outcome. Singapore Med J 1999;40:130–2Google Scholar
26 Tomkinson, A, Shone, GR, Dingle, A, Roblin, DG, Quine, S. Pharyngocutaneous fistula following total laryngectomy and post-operative vomiting. Clin Otolaryngol 1996;21:369–70CrossRefGoogle ScholarPubMed
27 Radaelli de Zinis, LO, Ferrari, L, Tomenzoli, D, Premoli, G, Parrinello, G, Nicolai, P. Postlaryngectomy pharyngocutaneous fistula: incidence, predisposing factors and therapy. Head Neck 1999;21:131–83.0.CO;2-F>CrossRefGoogle Scholar
28 Moses, BL, Eisele, DW, Jones, B. Radiologic assessment of early post-operative total laryngectomy patient. Laryngoscope 1993;103:1157–60CrossRefGoogle ScholarPubMed
29 Herranz, J, Sarandeses, A, Fernandez, MF, Barro, CV, Vidal, JM, Gavilan, J. Complications after total laryngectomy in nonradiated laryngeal and hypolaryngeal carcinomas. Otolaryngol Head Neck Surg 2000;122:892–8Google Scholar
30 Akyol, MU, Özdem, CC, Elikkanat, S. Early oral feeding after total laryngectomy. Ear Nose Throat J 1995;74:28–30CrossRefGoogle ScholarPubMed
31 Parikh, SR, Irish, JC, Curran, AJ, Gullane, PJ, Brown, DH, Rotstein, LE. Pharyngocutaneous fistulae in laryngectomy patients: the Toronto Hospital experience. J Otolaryngol 1998;27:136–40Google Scholar
32 Smith, TL, Burrage, KJ, Ganguly, P, Kirby, S, Drover, C. Prevention of postlaryngectomy pharyngocutaneous fistula. The Memorial University experience. J Otolaryngol 2003;32:222–5CrossRefGoogle ScholarPubMed
33 Wei, WI, Lam, KH, Wong, J, Ong, GB. Pharyngocutaneous fistula complicating total laryngectomy. Aust N Z J Surg 1980;50:366–9CrossRefGoogle ScholarPubMed
34 Seikaly, H, Park, P. Gastroesophageal reflux prophylaxis decreases the incidence of pharyngocutaneous fistula after total laryngectomy. Laryngoscope 1995;105:1220–2CrossRefGoogle ScholarPubMed
35 Kasapoglu, F, Erisen, L, Coskun, H, Basut, O, Tezel, I, Hizalan, I et al. The management of pharyngocutaneous fistulas after total laryngectomy and the factors affecting their incidence [in Turkish]. Kulak Burun Bogaz Ihtis Derg 2003;11:5–10Google ScholarPubMed
36 Morton, RP, Mehanna, H, Hall, FT, McIvor, NP. Prediction of pharyngocutaneous fistulas after laryngectomy. Otolaryngol Head Neck Surg 2007;136(suppl 4):S46–9CrossRefGoogle ScholarPubMed
37 Lavelle, RJ, Maw, AR. The aetiology of post-laryngectomy pharyngocutaneous fistulae. J Laryngol Otol 1972;86:785–93CrossRefGoogle Scholar
38 Horgan, EC, Dedo, HH. Prevention of major and minor fistulae after laryngectomy. Laryngoscope 1979;89:250–8CrossRefGoogle ScholarPubMed
39 Gray, D, Cooper, P. Nutrition on wound healing: what is the link? J Wound Care 2001;10:86–9CrossRefGoogle ScholarPubMed
40 Weigrad, DN, Spiro, RH. Complications after laryngectomy. Am J Surg 1983;146:517–20CrossRefGoogle Scholar
41 Heir, M, Black, MJ, Lafond, G. Pharyngocutaneous fistulas after total laryngectomy: incidence, etiology and outcome analysis. J Otolaryngol 1992;22:164–6Google Scholar
42 Sellars, SL. Complications of total laryngectomy. South Afr J Surg 1978;16:145–8Google ScholarPubMed
43 Gall, AM, Session, DG, Ogura, JH. Complications following surgery for cancer of the larynx and hypopharynx. Cancer 1977;39:624–313.0.CO;2-7>CrossRefGoogle ScholarPubMed
44 Sarkar, S, Mehta, SA, Tiwari, J, Mehta, AR, Mehta, MS. Complications following surgery for cancer of the larynx and piriform fossa. J Surg Oncol 1990;43:245–9CrossRefGoogle Scholar
45 Davidson, J, Briant, D, Gullane, P, Keane, T, Rawlinson, E. The role of surgery following radiotherapy failure for advanced laryngopharyngeal cancer. Arch Otolaryngol Head Neck Surg 1994;120:267–76CrossRefGoogle ScholarPubMed
46 Cavalot, AL, Gervasio, CF, Nazionale, G, Albera, R, Bussi, M, Staffieri, A et al. Pharyngocutaneous fistula as a complication of total laryngectomy. Review of the literature and analysis of case records. Otolaryngol Head Neck Surg 2000;123:587–92CrossRefGoogle ScholarPubMed
47 Qureshi, SS, Chaturvedi, P, Pai, PS, Chaukar, DA, Deshpande, MS, Pathak, KA et al. A retrospective study of pharyngocutaneous fistulas following total laryngectomy. J Can Res Ther 2005;1:51–6Google Scholar