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Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Feb;136(1):3-5. doi: 10.1016/j.anorl.2018.10.010. Epub 2018 Oct 25.

Assessment of swallowing function after circumferential pharyngolaryngectomy. A multicenter study by the GETTEC group.

Author information

1
Service d'ORL et de CCF, CHU Bretonneau, 2 Bd Tonnellé, 37000 Tours, France. Electronic address: moriniere@univ-tours.fr.
2
Service d'ORL et de CCF, IGR, 94800 Villejuif, France.
3
Service d'ORL et de CCF, CHU de Nantes, Nantes, France.
4
Service d'ORL et de CCF,CHU de Caen, Caen, France.
5
Service d'ORL et de CCF, CHU de Marseille, Marseille, France.
6
Service d'ORL et de CCF, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
7
Service d'ORL et de CCF, Hôpital Foch, Paris, France.
8
Service d'ORL et de CCF, CHU Poitiers, Poitiers, France.
9
Service d'ORL et de CCF, CHU Lyon, Lyon, France.
10
Service d'ORL et de CCF, CHU Toulouse, Toulouse, France.
11
Service d'ORL et de CCF, CHU Bichat, 75877 Paris, France.

Abstract

OBJECTIVE:

Circumferential pharyngolaryngectomy is performed for advanced pharyngeal tumor or in a context of postradiation recurrence. Several free or pedicle flaps have been described for pharyngeal defect reconstruction, with choice at the surgeon's discretion. The aim of this study was to evaluate long-term swallowing function according to the type of flap used for reconstruction.

MATERIAL AND METHOD:

A multicenter retrospective study was conducted from January to September 2016 within the French GETTEC head and neck tumor study group. All patients in remission after circumferential pharyngolaryngectomy were included and filled out the Deglutition Handicap Index (DHI) questionnaire and underwent swallowing function fiberoptic endoscopy assessment. 46 patients (39 men, 7 women) were included. Reconstruction used a tubularized forearm free flap (FFF group) in 19 cases, pectoralis major myocutaneous flap (PMMF group) in 15 cases and free jejunum flap (FJF group) in 12 cases.

RESULTS:

Mean DHI was 24: 20 in the FFF group, 23 in the FJF group and 25 in the PMMF group, without significant differences. 27 patients had normal swallowing, 9 mixed diet, 8 liquid diet and 3 were fed by gastrostomy. On endoscopy, free flaps (FJF and FFF) were associated with significantly greater rates of normal swallowing of saliva and yogurt than in the PMMF group (P=0.04).

CONCLUSION:

Type of flap reconstruction after circumferential pharyngolaryngectomy had no significant impact on postoperative swallowing function assessed on the self-administered DHI questionnaire.

KEYWORDS:

Cancer; Free flap; Pharyngolaryngectomy; Swallowing

PMID:
30482707
DOI:
10.1016/j.anorl.2018.10.010
[Indexed for MEDLINE]
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