Abstract
Objectives:
Review the swallowing outcomes of patients undergoing salvage transoral laser microsurgery (TLM) for laryngeal squamous cell carcinoma.
Methods:
A retrospective chart review was conducted at an academic practice in a regional referral center. Forty-one patients were identified with recurrent squamous cell carcinoma of the larynx after definitive radiation therapy from 2001 to 2013. Twenty-seven patients had glottic recurrences while 14 had recurrences in the supraglottis. Swallowing outcomes were evaluated by the necessity for a gastrostomy tube and the M.D. Anderson Dysphagia Index (MDADI) questionnaire.
Results:
The mean value of patients with a preoperative MDADI was 78.25. The mean value of patients with a postoperative MDADI was 73.6. The mean change in patients who completed a pre- and postoperative MDADI was a decrease by 4.9 points. Seventeen patients required a gastrostomy tube either placed during radiation treatment or perioperatively to their TLM procedure. Thirteen gastrostomy tubes were removed, 2 gastrostomy tubes were still in place, and 2 patients died with their gastrostomy tubes in place. All living patients resumed a regular, nonmodified diet.
Conclusions:
TLM is a successful surgical option for recurrent laryngeal cancer with acceptable swallowing outcomes.
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