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

被引：13

作者：

Gadepalli, C. ^{[1
]}

de Casso, C. ^{[1
]}

Silva, S. ^{[1
]}

Loughran, S. ^{[1
]}

Homer, J. J. ^{[1
,2
]}

机构：

[1] Manchester Royal Infirm, Manchester Acad Hlth Sci Ctr, Dept Otolaryngol Head & Neck Surg, Manchester M13 9WL, Lancs, England

[2] Univ Manchester, Sch Canc & Enabling Sci, Manchester M13 9PL, Lancs, England

来源：

JOURNAL OF LARYNGOLOGY AND OTOLOGY | 2012年 / 126卷 / 01期

关键词：

Voice; Swallowing; Laryngectomy; Pharyngectomy; Carcinoma; CIRCUMFERENTIAL PHARYNGOESOPHAGEAL RECONSTRUCTION; ANTEROLATERAL THIGH FLAP; SALIVARY BYPASS TUBE; QUALITY-OF-LIFE; NECK-CANCER; MORBIDITY; OUTCOMES; HEAD;

D O I：

10.1017/S0022215111002313

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

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.

引用

页码：52 / 57

页数：6

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