{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T16:11:02Z","timestamp":1772640662781,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare functional outcomes of total laryngectomy (TL) with microvascular free tissue transfer (MVFTT) reconstruction in the treatment of dysfunctional larynx (DL) versus salvage therapy for locally recurrent disease in patients with a history of laryngeal squamous cell carcinoma (SCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review from a tertiary medical center between August 2015 and August 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010nine patients underwent TL with MVFTT following primary laryngeal radiation or chemoradiation; 15 (22%) patients underwent functional laryngectomy (FL) and 54 (78%) underwent a salvage laryngectomy (SL). There were no total flap failures. Four (6%) patients developed a pharyngocutaneous fistula; one (7%) FL patient and 3 (6%) in the SL cohort. There was no significant difference in average hospital length of stay (LOS) between the cohorts (8.6\u2009\u00b1\u20093.0\u2009days vs. 12.8\u2009\u00b1\u200910.1\u2009days, <jats:italic>p<\/jats:italic>\u2009=\u20090.12). All patients (100%) in the FL cohort achieved a total oral diet compared to 41 (76%) in the SL cohort (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). Two (13%) and 10 (19%) patients developed pharyngoesophageal stenosis in the FL and SL cohorts, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20091.0). Nine (60%) and 23 (43%) patients in the FL and SL cohorts underwent tracheoesophageal puncture (TEP) placement, with 89% and 91% achieving fluency, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.23).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although the role of TL for the definitive treatment of laryngeal SCC has decreased over the past 30\u2009years, organ\u2010preservation protocols can impact speech, swallowing, and airway protection with life\u2010threatening consequences. The use of elective FL with MVFTT for the treatment of DL results in similar or better functional outcomes compared to SL for recurrent disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 134:222\u2013227, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30844","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T17:53:59Z","timestamp":1687629239000},"page":"222-227","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcome Comparison of Functional Laryngectomy for the Dysfunctional Larynx to Salvage Laryngectomy"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7556-8520","authenticated-orcid":false,"given":"Caitlin M.","family":"Coviello","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4576-5966","authenticated-orcid":false,"given":"David J.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. Eddie","family":"Liou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9205-385X","authenticated-orcid":false,"given":"Vlad C.","family":"Sandulache","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela D.","family":"Haskins","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erich M.","family":"Sturgis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8588-9264","authenticated-orcid":false,"given":"Andrew T.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Baylor College of Medicine  Houston Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197509000-00009"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199106133242402"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820947702"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00455-009-9247-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813503802"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/ARCHOTOL.130.9.1100"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.IJROBP.2010.07.013"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/HED.23275"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2012.742205"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.26760"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/CNCR.29207"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/HED.21352"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.EJSO.2016.05.017"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/CNCR.20974"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/ARCHOTOL.1995.01890020024006"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0B013E3180332E39"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/HED.20492"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.24619"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215114000504"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.28939"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000757"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/CNCR.33185"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-386456-7.01913-4"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811432264"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/ARCHOTO.2012.862"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200107000-00011"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/LIO2.430"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/HED.25508"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211000424"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25367"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/HED.24529"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30844","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T12:59:40Z","timestamp":1719925180000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30844"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,22]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/lary.30844"],"URL":"https:\/\/doi.org\/10.1002\/lary.30844","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,22]]},"assertion":[{"value":"2023-03-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}