BACKGROUND: Total aspiration is a rare complication after extended laser surgery for laryngeal cancer with adjuvant radiotherapy. PATIENTS AND METHODS: Two patients with long-standing total aspiration after laser surgery with radiotherapy despite intensified swallowing therapy were treated with an extended medialization thyroplasty. RESULTS: Postoperatively, both patients were able to swallow food and liquids without aspiration. One patient no longer has a gastrostomy tube and has been free from aspiration with normal oral food intake for 3 years. The second patient, with a tiny mucosal scar perforation, developed an abscess 2 months after surgery and needed revision surgery, with a subsequent return of aspiration. DISCUSSION: The second patient's complication stresses the significance of an intact endolaryngeal scar because of the well-known prolonged healing of mucosa in the irradiated larynx. In our opinion, the potential benefits of medialization thyroplasty outweigh the risk of significant complications, especially after irradiation.
BACKGROUND: Total aspiration is a rare complication after extended laser surgery for laryngeal cancer with adjuvant radiotherapy. PATIENTS AND METHODS: Two patients with long-standing total aspiration after laser surgery with radiotherapy despite intensified swallowing therapy were treated with an extended medialization thyroplasty. RESULTS: Postoperatively, both patients were able to swallow food and liquids without aspiration. One patient no longer has a gastrostomy tube and has been free from aspiration with normal oral food intake for 3 years. The second patient, with a tiny mucosal scar perforation, developed an abscess 2 months after surgery and needed revision surgery, with a subsequent return of aspiration. DISCUSSION: The second patient's complication stresses the significance of an intact endolaryngeal scar because of the well-known prolonged healing of mucosa in the irradiated larynx. In our opinion, the potential benefits of medialization thyroplasty outweigh the risk of significant complications, especially after irradiation.