Functional Swallowing Outcomes after Transoral Robotic Supraglottic Laryngectomy

Abstract

Objectives: (1) Defining functional swallowing outcomes as well as determining an expected length of time for patients to safely return to a normal oral diet in transoral robotic surgery (TORS) for resection of supraglottic laryngeal cancer. Methods: Retrospective chart review of patients who underwent TORS for resection of laryngeal cancer from 2011-2013. ASHA’s National Outcomes Measurement System, oral diet levels, and dependency on tube feedings were used as outcome measures. Results: Eleven patients were included in this study. Five out of 11 patients completed the treatment program and follow-up care, 100% returned to full oral diets in an average of 18.6 weeks, and all subsequently had their g-tube removed. Sixty percent of these patients continued to require compensatory swallowing techniques (ie, supraglottic swallowing maneuver) and/or modified diets (ie, thickened liquids) in order to safely consume oral diet without aspiration. Two patients died; 1 patient was lost to follow-up; 3 patients were still NPO at last contact. Conclusions: Patients who have undergone supraglottic laryngectomy will likely experience significant dysphagia, but good functional swallowing outcomes should be expected in the intermediate term.