OBJECTIVES/HYPOTHESIS: There are many treatments available for advanced oropharyngeal cancer. Organ-sparing protocols reserve surgery for salvage and are thought to provide adequate rehabilitation. Surgical resection with free tissue transfer may also provide adequate functional rehabilitation. The objective was to describe swallowing status and time to decannulation in a series of patients treated with combined-modality therapy that included free flap reconstruction. STUDY DESIGN: Retrospective chart review. METHODS: Patient data were obtained from medical records of 20 patients with stage III or IV oropharyngeal carcinoma, who were consecutively treated with surgical tumor extirpation, free flap reconstruction, and postoperative irradiation at a tertiary academic center from 1985 to 2002. The following variables were identified: patient and tumor characteristics, free flap type, irradiation data, and airway and swallowing status before and after treatment. RESULTS: One patient underwent total laryngopharyngectomy, and the remaining 19 patients underwent tracheotomy at the time of definitive surgery. Free flap reconstructions included 1 ulnar and 15 radial forearm fasciocutaneous flaps and 4 fibula osteocutaneous flaps. Postoperatively, all 19 tracheotomized patients had successful decannulation. Average time to decannulation was 15 days (range, 3-42 d). After surgery and before irradiation, 13 patients initiated oral intake, on average, at 19.5 days (range, 7-28 d); 6 patients required no additional supplementation. By 4 months after surgery, having completed radiation therapy, 10 patients were consuming all nutrition orally; the other 10 patients still required tube-feed supplementation, although 6 of these patients were also eating by mouth. CONCLUSION: Combined-modality treatment that includes free flap reconstruction for advanced-stage oropharyngeal cancer may provide reasonable functional rehabilitation with respect to postoperative airway and swallowing.
OBJECTIVES/HYPOTHESIS: There are many treatments available for advanced oropharyngeal cancer. Organ-sparing protocols reserve surgery for salvage and are thought to provide adequate rehabilitation. Surgical resection with free tissue transfer may also provide adequate functional rehabilitation. The objective was to describe swallowing status and time to decannulation in a series of patients treated with combined-modality therapy that included free flap reconstruction. STUDY DESIGN: Retrospective chart review. METHODS:Patient data were obtained from medical records of 20 patients with stage III or IV oropharyngeal carcinoma, who were consecutively treated with surgical tumor extirpation, free flap reconstruction, and postoperative irradiation at a tertiary academic center from 1985 to 2002. The following variables were identified: patient and tumor characteristics, free flap type, irradiation data, and airway and swallowing status before and after treatment. RESULTS: One patient underwent total laryngopharyngectomy, and the remaining 19 patients underwent tracheotomy at the time of definitive surgery. Free flap reconstructions included 1 ulnar and 15 radial forearm fasciocutaneous flaps and 4 fibula osteocutaneous flaps. Postoperatively, all 19 tracheotomized patients had successful decannulation. Average time to decannulation was 15 days (range, 3-42 d). After surgery and before irradiation, 13 patients initiated oral intake, on average, at 19.5 days (range, 7-28 d); 6 patients required no additional supplementation. By 4 months after surgery, having completed radiation therapy, 10 patients were consuming all nutrition orally; the other 10 patients still required tube-feed supplementation, although 6 of these patients were also eating by mouth. CONCLUSION: Combined-modality treatment that includes free flap reconstruction for advanced-stage oropharyngeal cancer may provide reasonable functional rehabilitation with respect to postoperative airway and swallowing.
Authors: J Scott Magnuson; Jennifer Durst; Eben L Rosenthal; William R Carroll; Christine S Ritchie; Meredith L Kilgore; Julie L Locher Journal: Head Neck Date: 2012-04-14 Impact factor: 3.147
Authors: Talya Salz; Rebecca B Schnall; Mary S McCabe; Kevin C Oeffinger; Stacie Corcoran; Andrew J Vickers; Andrew L Salner; Ellen Dornelas; Nirupa J Raghunathan; Elizabeth Fortier; Janet McKiernan; David J Finitsis; Susan Chimonas; Shrujal Baxi Journal: JCO Clin Cancer Inform Date: 2018-12
Authors: Vivek R Varma; Antoine Eskander; Stephen Y Kang; Bhavna Kumar; Nicole V Brown; Songzhu Zhao; Guy Brock; Amit Agrawal; Ricardo L Carrau; Matthew O Old; Enver Ozer; James W Rocco; David E Schuller; Peter T Dziegielewski; Michael J Cipolla; Theodoros N Teknos Journal: Laryngoscope Date: 2018-09-08 Impact factor: 3.325
Authors: Talya Salz; Mary S McCabe; Kevin C Oeffinger; Stacie Corcoran; Andrew J Vickers; Andrew L Salner; Ellen Dornelas; Rebecca Schnall; Nirupa J Raghunathan; Elizabeth Fortier; Shrujal S Baxi Journal: Pilot Feasibility Stud Date: 2016-05-05