Risk factors for dysphagia after transoral videolaryngoscopic surgery for laryngeal and pharyngeal cancer

Head Neck. 2016 Feb;38(2):196-201. doi: 10.1002/hed.23866. Epub 2015 May 22.

Abstract

Background: Transoral surgery is gaining attention as a minimally invasive treatment option for laryngeal and pharyngeal cancer. Postoperative swallowing function is satisfactory in most cases, but occasionally dysphagia persists.

Methods: Swallowing function of 86 patients who underwent transoral videolaryngoscopic surgery (TOVS) for laryngeal and pharyngeal cancers was evaluated by the Functional Outcome Swallowing Scale (FOSS) and risk factors for dysphagia were identified.

Results: FOSS stage was 0 to 1 in 90%, 2 in 5.8%, 3 in 3.5%, and 4 in 1.2% of the patients. Only 1 patient had indication for percutaneous endoscopic gastrostomy (PEG). Univariate analysis revealed that resection of the pyriform sinus (p = .0280) and arytenoid (p = .0139), pulmonary dysfunction (p = .0353), and large mucosal defect (p = .0223) were associated with postoperative dysphagia.

Conclusion: Although the rate of PEG dependency is low in transoral surgery, surgeons should mention the risk of postoperative dysphagia when counseling patients preoperatively.

Keywords: dysphagia; laryngeal cancer; pharyngeal cancer; risk analysis; transoral videolaryngoscopic surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arytenoid Cartilage / surgery
  • Deglutition Disorders / etiology*
  • Female
  • Humans
  • Laryngeal Neoplasms / surgery*
  • Laryngoscopy*
  • Lung Diseases / complications
  • Male
  • Middle Aged
  • Pharyngeal Neoplasms / surgery*
  • Postoperative Complications*
  • Pyriform Sinus / surgery
  • Respiratory Mucosa / pathology
  • Respiratory Mucosa / surgery
  • Risk Factors
  • Video Recording