Abstract
Objective: Postlaryngectomy stricture formation and dysphagia negatively impact the quality of life and result in nutritional compromise. Understanding risk factors and successful treatment strategies may improve treatment outcomes.
Method: 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 263 laryngectomies and the majority (82%) occurred in the first year. Stricture formation rates were similar for primary (19%) and salvage laryngectomy (18%) patients. Tubed flap reconstruction significantly increased the incidence of stricture formation (P ≤ .01) in salvage laryngectomy cases. In primary laryngectomy patients, stricture formation was not correlated with flap reconstruction or adjuvant radiation therapy. Patients requiring only a single dilation had better dietary outcomes (semi-solid) compared to patients requiring serial dilations. Stricture formation was associated with improved overall disease free survival (P ≤ .01) and recurrence rates (P = .06).
Conclusion: Stricture formation occurs equally in salvage and primary laryngectomies and is associated with an improved disease-free survival.
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