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Otolaryngol Head Neck Surg. 2012 Mar;146(3):395-402. doi: 10.1177/0194599811430911. Epub 2011 Dec 13.

Incidence and outcomes of stricture formation postlaryngectomy.

Author information

1
Department of Surgery, Division of Otolaryngology--Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA.

Abstract

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.

PMID:
22166968
PMCID:
PMC3951323
DOI:
10.1177/0194599811430911
[Indexed for MEDLINE]
Free PMC Article

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