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.
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.
Authors: Janice L Farlow; Andrew C Birkeland; Anna Hardenbergh; Teresa Lyden; J Chad Brenner; Andrew G Shuman; Steven B Chinn; Chaz L Stucken; Kelly M Malloy; Jeffrey S Moyer; Keith A Casper; Mark E P Prince; Carol R Bradford; Gregory T Wolf; Douglas B Chepeha; Andrew J Rosko; Matthew E Spector Journal: Eur Arch Otorhinolaryngol Date: 2020-01-27 Impact factor: 2.503
Authors: Ashley C Mays; Bharat Yarlagadda; Virginie Achim; Ryan Jackson; Patrik Pipkorn; Andrew T Huang; Karthik Rajasekaran; Shaum Sridharan; Andrew J Rosko; Ryan K Orosco; Andrew M Coughlin; Mark K Wax; Yelizaveta Shnayder; William C Spanos; Donald Gregory Farwell; Lee S McDaniel; Matthew M Hanasono Journal: Head Neck Date: 2021-01-08 Impact factor: 3.147
Authors: Laila A Gharzai; Julia Pakela; Elizabeth M Jaworski; Issam El Naqa; Jennifer Shah; Peter G Hawkins; Matthew E Spector; Carol R Bradford; Steven B Chinn; Kelly Malloy; Robbi Kupfer; Andrew Shuman; Robert Morrison; Chaz L Stucken; Andrew Rosko; Mark E Prince; Keith Casper; Avraham Eisbruch; Gregory Wolf; Paul L Swiecicki; Francis Worden; Michelle L Mierzwa Journal: Clin Transl Radiat Oncol Date: 2021-12-23
Authors: Christian Simon; Avinash Beharry; Vinidh Paleri; Pascaline Dübi; Karma Lambercy; F Christopher Holsinger; Jelena Todic Journal: Head Neck Date: 2022-06-02 Impact factor: 3.821