Complications that affect postlaryngectomy voice restoration: Primary surgery vs salvage surgery

Heather M. Starmer, Stacey L. Ishman, Paul W. Flint, Nasir I. Bhatti, Jeremy Richmon, Wayne Koch, Kimberly Webster, Ralph Tufano, Christine G. Gourin

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objective: To assess the effect of primary treatment on tracheoesophageal voice prosthesis (TEP) complications. Design: Retrospective cohort study. Setting: The Johns Hopkins Medical Institutions, Baltimore, Maryland. Patients: Patients who underwent total laryngectomy and TEP between January 1, 1998, and December 31, 2008, were divided into 3 subgroups according to primary treatment: surgery (n = 81), radiotherapy (n = 61), and chemoradiotherapy (n = 32). Main Outcome Measures: Number of weeks before leakage through the TEP, occurrence of leakage around the TEP, TEP dislodgement, and size changes 6 months or longer after laryngectomy. Results: A total of 174 patients met the study criteria. Of the 81 patients who underwent primary surgery, 81% (n = 66) underwent adjuvant therapy with postoperative radiotherapy or chemoradiotherapy. The incidence of leakage around the prosthesis, prosthesis dislodgement, and size changes 6 months or longer after laryngectomy were significantly higher for patients who required salvage total laryngectomy after chemoradiotherapy or radiotherapy (P < .05). In addition, significantly more patients who underwent salvage total laryngectomy required extended laryngectomy or free tissue reconstruction. Conclusions: Voice prosthesis complications are more frequently encountered in those who require salvage laryngectomy. Understanding the potential for such complications reinforces the need for close communication and follow-up with these patients by the speech language pathologist.

Original languageEnglish (US)
Pages (from-to)1165-1169
Number of pages5
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume135
Issue number11
DOIs
StatePublished - Nov 1 2009

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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    Starmer, H. M., Ishman, S. L., Flint, P. W., Bhatti, N. I., Richmon, J., Koch, W., Webster, K., Tufano, R., & Gourin, C. G. (2009). Complications that affect postlaryngectomy voice restoration: Primary surgery vs salvage surgery. Archives of Otolaryngology - Head and Neck Surgery, 135(11), 1165-1169. https://doi.org/10.1001/archoto.2009.168