Functional outcomes and quality of life after total laryngectomy with noncircumferential radial forearm free tissue transfer

Head Neck. 2017 Nov;39(11):2319-2328. doi: 10.1002/hed.24902. Epub 2017 Aug 24.

Abstract

Background: The purpose of this study was to compare long-term functional and quality of life (QOL) outcomes after total laryngectomy with primary closure and those who underwent reconstruction with noncircumferential radial free forearm tissue transfer (RFFTT).

Methods: Sixty-seven patients were identified by chart review and underwent long-term follow-up using QOL surveys and standardized interviews.

Results: The RFFTT group had significantly higher rates of chemotherapy, gastric tube (G-tube) at surgery, and postoperative stricture. At follow-up, most patients (88%) had a tracheoesophageal prosthesis (TEP) and were using it as their primary communication method. Diet and swallowing outcomes were comparable and no one had a G-tube. Device life and TEP complications did not differ significantly. Only voice-related QOL differed significantly between the RFFTT group and those who had undergone total laryngectomy without adjuvant treatment.

Conclusion: Despite more extensive treatment, the reconstructed group achieved comparable outcomes to those who had undergone total laryngectomy with adjuvant treatment.

Keywords: diet; flap; laryngectomy; quality of life; tracheoesophageal puncture.

MeSH terms

  • Aged
  • Cohort Studies
  • Deglutition / physiology
  • Female
  • Forearm
  • Free Tissue Flaps*
  • Humans
  • Laryngeal Neoplasms / physiopathology
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy*
  • Larynx, Artificial
  • Male
  • Middle Aged
  • Plastic Surgery Procedures*
  • Quality of Life*
  • Recovery of Function
  • Treatment Outcome
  • Voice / physiology*