{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T17:59:22Z","timestamp":1776535162382,"version":"3.51.2"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,7,17]],"date-time":"2017-07-17T00:00:00Z","timestamp":1500249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To evaluate functional outcomes and complication rate after total laryngectomy (TL) for dysfunctional larynx with end\u2010stage dysphagia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Chart review was performed on all patients who underwent TL from January 2008 to July 2016 at a single tertiary academic medical center. Patients who underwent TL for dysfunctional larynx without preoperative evidence of malignancy were included. Main outcome measures were post\u2010TL functional swallowing and speech outcomes, and complication rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 19 patients from a cohort of 278 consecutive patients. All patients were previously treated with radiotherapy (RT), whereas 13\/19 (68%) previously received chemoradiotherapy. The median time from RT to TL was 10.98 years (range, 0.67\u201323.94 years). Aspiration was evident preoperatively in 17\/19 (89%) patients, with 11 experiencing recurrent aspiration pneumonia. Seventeen of 19 (89%) patients were nil per os (NPO) requiring enteral nutrition. Six of 19 (32%) patients had surgical complications, including three (16%) pharyngocutaneous fistulas. At 3\u2010month and 1\u2010year postoperative follow\u2010up, there was significant improvement in mean Functional Oral Intake Scale (FOIS) score and aspiration, recurrent pneumonia, enteral nutrition, and NPO status rates (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05). At 1\u2010year follow\u2010up, no patients were NPO, and only one patient required gastrostomy tube supplementation. Mean FOIS score increased from 1.3 to 6.1 (<jats:italic>P<\/jats:italic>\u2009=\u2009.001). Eight of 13 patients (62%) were actively using a tracheoesophageal prosthesis at 1\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Laryngectomy for dysfunctional larynx eliminates the morbidity of aspiration while improving diet and reducing gastrostomy tube dependence with an acceptable complication rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 128:597\u2013602, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26760","type":"journal-article","created":{"date-parts":[[2017,7,17]],"date-time":"2017-07-17T09:04:44Z","timestamp":1500282284000},"page":"597-602","source":"Crossref","is-referenced-by-count":16,"title":["Safety and efficacy of functional laryngectomy for end\u2010stage dysphagia"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6728-3418","authenticated-orcid":false,"given":"Michael C.","family":"Topf","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda C.","family":"Maga\u00f1a","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University Philadelphia Pennsylvania U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Salmon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William M.","family":"Keane","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Luginbuhl","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M.","family":"Curry","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Cognetti","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurits","family":"Boon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph R.","family":"Spiegel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck 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