Journal
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Volume -, Issue -, Pages -Publisher
WILEY
DOI: 10.1002/hed.27545
Keywords
functional outcomes; larynx cancer; stricture; total laryngectomy; total laryngopharyngectomy
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The risk factors for dysphagia refractory to a single dilation after TL/TLP include pharyngocutaneous fistula, primary chemoradiation therapy, and a shorter time interval from TL/TLP to first dilation. Patients requiring multiple dilations are at increased risk of persistent dysphagia long-term.
BackgroundFollowing total laryngectomy (TL) or laryngopharyngectomy (TLP), patients may develop strictures that require multiple dilations to treat. However, the risk factors associated with dysphagia refractory to a single dilation are unknown.MethodsSingle-institution retrospective review of patients who underwent at least one stricture dilation after TL/TLP between March 2013 and March 2022.ResultsA total of 49 patients underwent stricture dilation after TL/TLP. Thirty-five (71%) underwent multiple dilations. Pharyngocutaneous fistula, primary chemoradiation therapy, and a shorter time interval from TL/TLP to first dilation were independently associated with dysphagia requiring multiple dilations. Patients in the multiple dilations group had a higher rate of limited diet and G-tube dependence compared to patients in the single dilation group.ConclusionsShorter time interval to stricture formation is a prognostic indicator of the need for multiple dilations following TL/TLP. Patients requiring multiple dilations are at increased risk of persistent dysphagia long-term.
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