Incidence and Outcomes of Stricture Formation Postlaryngectomy

Objective. Postlaryngectomy stricture formation and dysphagia negatively affect quality of life and result in nutritional compromise. Understanding risk factors and successful treatment strategies may improve treatment outcomes. Study Design. Historical cohort study. Setting. Tertiary care medical c...

Full description

Saved in:
Bibliographic Details
Published in:Otolaryngology-head and neck surgery 2012-03, Vol.146 (3), p.395-402
Main Authors: Sweeny, Larissa, Golden, J. Blake, White, Hilliary N., Magnuson, J. Scott, Carroll, William R., Rosenthal, Eben L.
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Cohort Studies
Confidence Intervals
Constriction, Pathologic - epidemiology
Constriction, Pathologic - etiology
Disease-Free Survival
Female
Follow-Up Studies
head and neck
Humans
Incidence
Kaplan-Meier Estimate
Laryngeal Neoplasms - mortality
Laryngeal Neoplasms - pathology
Laryngeal Neoplasms - surgery
Laryngectomy - adverse effects
Laryngectomy - methods
Laryngostenosis - epidemiology
Laryngostenosis - etiology
Laryngostenosis - pathology
Male
Middle Aged
Neoplasm Invasiveness - pathology
Neoplasm Staging
Odds Ratio
Postoperative Complications - epidemiology
Postoperative Complications - pathology
Retrospective Studies
Risk Assessment
Sex Distribution
squamous cell carcinoma
stricture
survival
Survival Analysis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective. Postlaryngectomy stricture formation and dysphagia negatively affect quality of life and result in nutritional compromise. Understanding risk factors and successful treatment strategies may improve treatment outcomes. Study Design. Historical cohort study. Setting. Tertiary care medical center. Subjects and Methods. Patients at a tertiary care center who underwent a total laryngectomy between 2003 and 2009 (N = 263) were evaluated in a retrospective manner. Patient demographics, comorbidities, tobacco and alcohol usage, dietary outcomes, feeding tube dependence, and treatment modalities were assessed. Management strategies and outcomes were evaluated. Results. Strictures developed in 19% (n = 49) of patients, and the majority (82%) occurred in the first year. Incidences of stricture formation were similar for primary (19%) and salvage laryngectomy (19%) patients. Patients undergoing salvage laryngectomy were 2 times more likely to be reconstructed with a free flap, whereas those undergoing a primary laryngectomy were 3 times more likely to be closed primarily. Tubed flap reconstruction significantly increased the incidence of stricture formation compared to primary closure (P = .02) in salvage laryngectomy cases. In primary laryngectomy patients, stricture formation did not correlate with flap reconstruction (P = .34) or adjuvant radiation therapy (P = .79). Patients who required a single dilation had better dietary outcomes compared to patients who required serial dilations (P = .14). There was no difference in overall disease-free survival in primary vs salvage laryngectomy patients (P = .95). Conclusion. Rates of stricture formation were the same in patients undergoing salvage compared to primary total laryngectomy.
ISSN:0194-5998
1097-6817
DOI:10.1177/0194599811430911