Swallowing ability and chronic aspiration after supracricoid partial laryngectomy

OBJECTIVE: Sporadic episodes of aspiration may occur after supracricoid partial laryngectomy. To prevent risks of pulmonary consequences, a limitation of oral intake of food or a nothing by mouth regimen has been suggested. The objective of this study was to evaluate the long-term swallowing and pulmonary status of patients after supracricoid partial laryngectomy. STUDY DESIGN: Case series with chart review. SETTING: Tertiary University Hospital Policlinico Umberto I and Santa Lucia Foundation, Rome, Italy. SUBJECTS AND METHODS: The swallowing status of a selected group of 116 patients who recovered functional deglutition after supracricoid partial laryngectomy was analyzed during follow-up consultation. Swallowing evaluation included clinical observation, fiberoptic endoscopic evaluation of swallowing, and a videofluoroscopy. When aspiration was confirmed by videofluoroscopy, a high-resolution computed tomography (CT) of the chest was performed in order to assess the radiological manifestations of aspiration. A group of 45 patients with chronic obstructive pulmonary disease and normal deglutition was used as a control. RESULTS: Seventy-nine patients out of 116 showed a fiberoptic endoscopic evaluation of swallowing suggestive for aspiration; only 45 patients had aspiration confirmed by videofluoroscopy. No significant differences in radiological findings were noted in the patients affected by postoperative chronic aspiration compared to the control group. CONCLUSION: Patients with functional deglutition after supracricoid partial laryngectomy show a mild and well-tolerated degree of chronic aspiration and do not require a limitation of oral intake of food. (C) 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.