Hostname: page-component-594f858ff7-r29tb Total loading time: 0 Render date: 2023-06-08T12:23:13.198Z Has data issue: false Feature Flags: { "corePageComponentGetUserInfoFromSharedSession": true, "coreDisableEcommerce": false, "corePageComponentUseShareaholicInsteadOfAddThis": true, "coreDisableSocialShare": false, "useRatesEcommerce": true } hasContentIssue false
  • English

Variation in surgical methods used for total laryngectomy in Australia

Published online by Cambridge University Press:  08 March 2017

J Maclean ,
S Cotton  and
A Perry
J Maclean*
Affiliation:
Cancer Care Centre, St George Hospital, Sydney, New South Wales, Australia
S Cotton
Affiliation:
ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Australia
A Perry
Affiliation:
School of Human Communication Sciences, La Trobe University, Melbourne, Victoria, Australia
*
Address for correspondence: Ms Julia Maclean, Cancer Care Centre, St George Hospital, Short St, Kogarah, NSW, Australia2217. Fax: +61 2 9113 3935 E-mail: Julia.Maclean@sesiahs.health.nsw.gov.au
Get access Rights & Permissions[Opens in a new window]

Abstract

Deglutition disorders (dysphagia) are common following total laryngectomy. As the aetiology of the disorder is poorly understood, its incidence is probably under-estimated. Dysphagia may result from many factors, including the type of laryngectomy surgery employed and the use of adjuvant treatments (e.g. radiotherapy and chemotherapy). Dysphagia may also be compounded by other co-morbid factors, such as ageing and depression.

Aim:

To investigate the methods of surgical closure used by Australian ENT and head and neck surgeons after undertaking total laryngectomy surgery.

Method:

In order to audit surgical variation, 56 short questionnaires were sent to all Australian ENT and head and neck surgeons who were registered members of the Australia and New Zealand Head and Neck Society. Twenty-eight questionnaires (50 per cent) were completed and returned.

Results:

Respondents reported using a variety of different reconstructive methods after total laryngectomy surgery. Specifically, there were differences in the type and levels of pharyngeal closure employed and the suturing techniques used.

Conclusion:

Currently, there is no scientific evidence to direct surgeons to the optimal pharyngeal reconstruction technique(s) ensuring for good swallowing results post-laryngectomy. An analysis of the effect of surgical reconstruction technique on laryngectomees' post-operative swallowing ability is needed, in order to provide evidence to determine optimal surgical techniques.

Keywords

Deglutition DisordersTotal LaryngectomySurgical Procedures
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 7 , July 2008 , pp. 728 - 732
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented as a poster at the European Group for Functional Reconstruction after Laryngectomy meeting was held June 9–12 2007, the Annual Scientific Meeting of the Australian and New Zealand Head and Neck Society was held July 26–28 2007, Brisbane, Queensland, Australia.

References

1 Ward, EC, Bishop, B, Frisby, J, Stevens, M. Swallowing outcomes following laryngectomy and pharyngolaryngectomy. Arch Otolaryngol Head Neck Surg 2002;128:181–6CrossRefGoogle ScholarPubMed
2 Freeman, SB, Hamaker, RC. Tracheosophageal voice restoration at the time of laryngectomy. In: Blom, ED, Singer, MI, Hamaker, RC, eds. Tracheoesophageal Voice Restoration Following Total Laryngectomy. San Diego, California: Singular Publishing, 1998;19–25Google Scholar
3 Hamaker, RC, Cheesman, AD. Surgical management of pharyngeal constrictor muscle hypertonicity. In: Blom, ED, Singer, MI, Hamaker, RC, eds. Tracheoesophageal Voice Restoration Following Total Laryngectomy. San Diego, California: Singular Publishing, 1998;33–9Google Scholar
4 Edels, Y. Pseudo-voice: its theory and practice. In: Edels, Y, ed. Laryngectomy: Diagnosis to Rehabilitation. London: Croom-Helm, 1983;107–42Google Scholar
5 Dantas, RO, Aguiar-Ricz, LN, Gielow, I, Filho, FVM, Mamede, RCM. Proximal esophageal contractions in laryngectomized patients. Dysphagia 2005;20:101–4CrossRefGoogle ScholarPubMed
6 Cook, IJ. Disorders causing oropharyngeal dysphagia. In: Castell, DO, Richter, JE, eds. Esophagus, 4th edn. Pennsylvania: Lipcott Williams & Wilkins, 2002;196–220Google ScholarPubMed
7 Lindgren, M, Janzon, L. Prevalence of swallowing complaints and clinical findings among 50–79 year old men and women in an urban population. Dysphagia 1991;6:187–92CrossRefGoogle Scholar
8 Boyd, GM, Brodsky, MB, Day, TA, Lee, F, Martin-Harris, B. Swallowing-related quality of life after head and neck cancer treatment. Laryngoscope 2004;114:1362–7Google Scholar
9 Cole, I, Miller, S. Total laryngectomy with primary voice restoration. Aust N Z J Surg 1993;63:468–70CrossRefGoogle Scholar
10 Portney, LG, Watkins, MP. Surveys. In: Portney, LG, Watkins, MP. Foundations of Clinical Research Applications to Practice, 2nd edn. NJ: Prentice-Hall, 2000; 285–316Google Scholar