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Clinical outcomes following pharyngolaryngectomy reconstruction: a 20-year single-centre study

Published online by Cambridge University Press:  10 January 2022

T Layton Open the ORCID record for T Layton [Opens in a new window] ,
R Thomas ,
C Harris ,
S Holmes ,
L Fraser ,
P Silva  and
S C Winter
T Layton
Affiliation:
Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, England
R Thomas*
Affiliation:
Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, England
C Harris
Affiliation:
Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, England
S Holmes
Affiliation:
Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, England
L Fraser
Affiliation:
Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, England
P Silva
Affiliation:
Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, England
S C Winter
Affiliation:
Bleinheim Head and Neck Unit, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, England Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
*
Author for correspondence: Mr Thomas Layton, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, OxfordOX3 7FY, UK E-mail: Thomas.layton@kennedy.ox.ac.uk
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Abstract

Background

Advanced malignant neoplasms of the larynx and hypopharynx pose many therapeutic challenges. Total pharyngolaryngectomy and total laryngectomy provide an opportunity to cure these tumours but are associated with significant morbidity. Reconstruction of the pharyngeal defect following total pharyngolaryngectomy demands careful consideration and remains an area of debate within surgical discussions.

Methods

This paper describes a systemic analysis of pharyngeal reconstruction following total pharyngolaryngectomy and total laryngectomy, leveraging data collected over a 20-year period at a large tertiary referral centre.

Results

Analysing 155 patients, the results show that circumferential pharyngeal defects and prior radiotherapy have a significant impact on surgical complications. In addition, free tissue transfer in larger pharyngeal defects showed lower rates of post-operative anastomosis leak and stricture.

Conclusion

Pharyngeal resection carries a substantial risk of post-operative complications, and free tissue transfer appears to be an effective means of reconstruction for circumferential defects.

Keywords

OtolaryngologyHead And Neck CancerOutcomes Research
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 11 , November 2022 , pp. 1105 - 1112
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr T Layton takes responsibility for the integrity of the content of the paper

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