Effect of Functional Laryngectomy on Dysphagia

Tuesday, October 3, 2023

3:48 PM - 3:54 PM East Coast USA Time

Location: 201AB

Presenting Author(s)

Charles D. Mullins, B.S.

Medical Student
University of Arkansas for Medical Sciences
Little Rock, AR, United States

Senior Author(s)

OT

Ozlem E. Tulunay-Ugur, MD

Professor, Director Division of Laryngology
University of Arkansas
Little Rock, AR, United States

Co-Author(s)

JS

Jumin Sunde, MD

University of Arkansas for Medical Sciences, USA
Mauricio A. Moreno-Vera, MD

Professor
University of Arkansas for Medical Sciences
Little Rock, AR, United States
EV

Emre A. Vural, MD

Professor
University of Arkansas for Medical Sciences
Little Rock, AR, United States
Deanne L. King, MD, PhD

Associate Professor
University of Arkansas for Medical Sciences
Little Rock, AR, United States
Hayden Carl Hairston, MD

Resident Physician
University of Arkansas for Medical Sciences
Little Rock, AR, United States

Disclosure(s):

Ozlem E. Tulunay-Ugur, MD: No relevant relationships to disclose.

Introduction: Patients with severe dysphagia can undergo laryngectomy to reduce the risk of aspiration pneumonia and potentially improve swallowing outcomes. There is limited quantitative evidence looking at improvement in functional status after total laryngectomy for dysphagia.

Methods: This is a 7-year retrospective cohort study conducted between 2012 and 2019 evaluating patients who underwent laryngectomy at two tertiary academic medical centers for functional indication. Demographic, clinical, and perioperative data were obtained to identify the indication for laryngectomy and level of dysphagia. Pre- and post-operative data were used to score dysphagia from 1-7 according to the Dysphagia Outcome and Severity Scale (DOSS).

Results: 110 patients were identified in this cohort. Of these 12 (10.9%) underwent total laryngectomy for function indication. Organ failure was a result of post-chemo and radiation in 9 (75%), unknown etiology in 3 (25%) and post-stroke in 1 (8%). Of the 12 patients, 5 (42%) had a previous diagnosis of aspiration pneumonia. 6 patients (50%) were tracheostomy dependent, and 4 (25%) patients were NPO. There were no major post-operative complications. The average pre-operative dysphagia score was 3.5. The average post-operative dysphagia score was 6. This showed an improvement of 2.5 points on the DOSS scale after functional laryngectomy.

Conclusions: In this case series functional laryngectomies have clear benefit in improving swallow function and should be considered as a safe option for patients with laryngeal organ failure. Swallowing can indirectly be tied to quality of life, however further investigation into this outcome is needed in this population.