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Salvage laryngectomy and laryngopharyngectomy: Multicenter review of outcomes associated with a reconstructive approach.

Publication ,  Journal Article
Microvascular Committee of the American Academy of Otolaryngology-Head & Neck Surgery*,
Published in: Head Neck
January 2019

BACKGROUND: Surgeons have developed various reconstructive techniques to minimize the rate of pharyngocutaneous fistula and optimize functional outcome after salvage laryngectomy or laryngopharyngectomy. METHODS: Multicenter retrospective review at 33 institutions of 486 patients with a history of squamous cell carcinoma (SCC) of the larynx or hypopharynx previously treated with primary chemoradiotherapy (CRT) who required salvage surgery. Outcomes evaluated were overall fistula rate, fistula requiring reoperation, and 12-month speech and swallowing function. RESULTS: Primary closure of the hypopharynx was associated with a statistically higher overall fistula rate and fistula requiring reoperation compared to reconstruction with vascularized tissue augmentation. Vascularized tissue augmentation with muscle led to worse 12-month "understandability of speech" and "nutritional mode" scores compared to vascularized tissue augmentation without muscle. CONCLUSION: Vascularized tissue augmentation reduces the overall fistula rate and fistula requiring reoperation but vascularized tissue augmentation with muscle may impair speech and swallowing outcomes.

Duke Scholars

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Published In

Head Neck

DOI

EISSN

1097-0347

Publication Date

January 2019

Volume

41

Issue

1

Start / End Page

16 / 29

Location

United States

Related Subject Headings

  • Surgical Flaps
  • Speech Intelligibility
  • Salvage Therapy
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Pharyngectomy
  • Pharyngeal Diseases
  • Otorhinolaryngology
  • Middle Aged
 

Citation

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Microvascular Committee of the American Academy of Otolaryngology-Head & Neck Surgery*, . (2019). Salvage laryngectomy and laryngopharyngectomy: Multicenter review of outcomes associated with a reconstructive approach. Head Neck, 41(1), 16–29. https://doi.org/10.1002/hed.25192
Microvascular Committee of the American Academy of Otolaryngology-Head & Neck Surgery*, Ernest A. “Salvage laryngectomy and laryngopharyngectomy: Multicenter review of outcomes associated with a reconstructive approach.Head Neck 41, no. 1 (January 2019): 16–29. https://doi.org/10.1002/hed.25192.
Microvascular Committee of the American Academy of Otolaryngology-Head & Neck Surgery*. Salvage laryngectomy and laryngopharyngectomy: Multicenter review of outcomes associated with a reconstructive approach. Head Neck. 2019 Jan;41(1):16–29.
Microvascular Committee of the American Academy of Otolaryngology-Head & Neck Surgery*, Ernest A. “Salvage laryngectomy and laryngopharyngectomy: Multicenter review of outcomes associated with a reconstructive approach.Head Neck, vol. 41, no. 1, Jan. 2019, pp. 16–29. Pubmed, doi:10.1002/hed.25192.
Microvascular Committee of the American Academy of Otolaryngology-Head & Neck Surgery*. Salvage laryngectomy and laryngopharyngectomy: Multicenter review of outcomes associated with a reconstructive approach. Head Neck. 2019 Jan;41(1):16–29.
Journal cover image

Published In

Head Neck

DOI

EISSN

1097-0347

Publication Date

January 2019

Volume

41

Issue

1

Start / End Page

16 / 29

Location

United States

Related Subject Headings

  • Surgical Flaps
  • Speech Intelligibility
  • Salvage Therapy
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Pharyngectomy
  • Pharyngeal Diseases
  • Otorhinolaryngology
  • Middle Aged