Risk factors associated with aspiration after partial laryngectomies

Abstract

En Abstract Hypothesis Aspiration and dysphagia still remain the most common drawbacks limiting conservation partial laryngeal surgery. Videofluoroscopic swallowing study (VFSS) has became the gold standard examination that guides the surgeon about important risk factors, helping him in technique selection and anatomical structure preservation, in balance with radical removal of laryngeal neoplasms. Objectives The purpose of this study was to determine the major risk factors for postoperative aspiration using VFSS and how to overcome it following different types of partial laryngectomies. Study design The authors conducted a prospective evaluation comparative study. Patients and methods This study was conducted on patients with laryngeal carcinoma who underwent partial laryngectomy between October 2009 and May 2012. VFSS was carried out to evaluate postoperative swallowing and aspiration. Statistical analyses were performed using Pearson’s χ2 and Spearman’s rank correlation test to detect the major risk factors associated with aspiration. Results Thirty-two patients were enrolled in the present study. Six different types of partial laryngeal surgeries were carried out according to the size and extent of the primary tumor. Twenty-five (78.12%) patients suffered from various degrees of aspiration. Age, smoking, site of tumor, resection of valleculae, epiglottis, hyoid bone, ventricular folds, and true vocal folds were significantly associated with aspiration (P<0.05). Conclusion Aspiration is common after partial laryngeal surgeries but is rarely severe or permanent. VFSS should be used before and after any partial laryngectomy to exclude silent aspiration and the risk for aspiration pneumonia. Aspiration can be minimized with careful patient selection and precise surgical technique selection and perfection.

Keywords

• aspiration
• Modified Penetration Aspiration Scale
• partial laryngeal surgeries
• videofluoroscopic swallowing study