Abstract
Objective: 1) Evaluate the long-term voice and swallowing outcomes of supracricoid partial laryngectomy (SCPL). 2) Determine the effect of prior radiation therapy on voice and swallow outcomes.
Method: A retrospective chart review was performed on all patients that received SCPL at our institution between 2006 and 2010. Multiple parameters measuring voice and swallowing outcomes were recorded where available and descriptive statistics performed. Chi-square and Student t-test analysis were performed with P < .05 used to denote significance.
Results: Fourteen patients were identified, including 2 cricohyoidopexies and 11 cricohyiodoepiglottipexies. Mean follow-up was 650 ± 470 days. Decannulation occurred at 30 ± 16 days and feeding tube removal at 87 ± 43 days postoperatively. All patients tolerated regular diets and thin liquids. Maximum phonation time was 10.6 ± 6.1 sec, F0 was 161.7 ± 75.7 Hz, VHI was 35.6 ± 16.1, and CAPE-V dysphonia score was 56.3 ± 11.0. Comparing previously irradiated patients with those without prior radiation, there was no difference in time to feeding tube removal (100 ± 18 vs 79 ± 8 days, P = .32), maximum phonation time (9.3 ± 2.1 vs 12.6 ± 3.9 sec, P = .49) or VHI score (32.5 ± 9.4 vs 49.3 ± 1.8, P = .17), but F0 was significantly higher (235.5 ± 27.3 vs 115.1 ± 9.8 Hz, P = .01).
Conclusion: SCPL is well tolerated; patients have excellent swallowing and serviceable voice postoperatively. Preoperative radiation therapy appears to raise F0; otherwise voicing and return of swallow function is similar to those patients who have not been irradiated. Prospective studies may define other prognostic markers for voice and swallow outcomes after SCPL.
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