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.

Prospective analysis of functional swallowing outcome after resection of T2 glottic carcinoma using transoral laser surgery and external vertical hemilaryngectomy / H.O. Nasef, H. Thabet, C. Piazza, F. Del Bon, M. Eid, M.E. Banna, P. Nicolai. - In: EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY. - ISSN 0937-4477. - 273:8(2016), pp. 2133-2140. [10.1007/s00405-016-4065-7]

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

C. Piazza;
2016

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.
Conservative laryngeal surgery; Functional outcomes; Swallowing; Transoral laser surgery; Adult; Aged; Carcinoma, Squamous Cell; Chi-Square Distribution; Deglutition; Deglutition Disorders; Female; Glottis; Humans; Intubation, Gastrointestinal; Laryngeal Neoplasms; Laryngectomy; Laser Therapy; Length of Stay; Male; Microsurgery; Middle Aged; Neoplasm Staging; Postoperative Complications; Prospective Studies; Respiratory Aspiration of Gastric Contents; Statistics, Nonparametric; Tracheostomy; Treatment Outcome; Otorhinolaryngology2734 Pathology and Forensic Medicine
Settore MED/31 - Otorinolaringoiatria
link.springer.de/link/service/journals/00405/index.htm
Article (author)
File in questo prodotto:
File Dimensione Formato  
10.1007_s00405-016-4065-7.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 260.5 kB
Formato Adobe PDF
260.5 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/515995
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 10
  • ???jsp.display-item.citation.isi??? 7
social impact