{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T17:59:19Z","timestamp":1776535159726,"version":"3.51.2"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,1,10]],"date-time":"2012-01-10T00:00:00Z","timestamp":1326153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Total laryngectomy (TL) can be offered for management of chronic aspiration, radionecrosis, and\/or airway compromise after head and neck cancer (HNC) treatment. The objective of this study was to evaluate functional outcomes after TL in disease\u2010free HNC survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The University of Texas MD Anderson Cancer Center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Twenty\u2010three disease\u2010free HNC survivors who underwent TL for laryngopharyngeal dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>TL \u00b1 pharyngectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Post\u2010TL swallowing\u2010related (diet, gastrostomy dependence, and pneumonia rates) and communication outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients who underwent TL for dysfunction were previously treated with radiotherapy (12\/23, 52%) or chemoradiotherapy (11\/23, 48%). Preoperative complications included aspiration (22\/23, 96%), pneumonia (16\/23, 70%), tracheostomy (9\/23, 39%), and stricture (7\/23, 30%); 17 patients (74%) required enteral\/parenteral nutrition, and 13 of 23 (57%) were nothing per oral (NPO). Rates of pneumonia, NPO status, and feeding tube dependence significantly decreased after TL (<jats:italic>P<\/jats:italic> &lt;. 001). At last follow\u2010up after TL, all patients tolerated oral intake, but 4 (17%) required supplemental enteral nutrition. Continued smoking after radiotherapy and a preoperative history of recurrent pneumonia were significantly (<jats:italic>P<\/jats:italic> &lt;. 05) associated with final tube dependence and\/or diet level. Sixteen patients (70%) underwent tracheoesophageal (TE) puncture, and 57% (13 of 23) communicated using TE voice after TL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Salvage TL may improve health status by significantly decreasing the rate of pneumonia and improve quality of life by restoring oral intake in patients with refractory laryngopharyngeal dysfunction after HNC treatment. TE voice restoration may enhance functional outcomes in select patients treated with elective TL for dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599811432264","type":"journal-article","created":{"date-parts":[[2012,1,11]],"date-time":"2012-01-11T00:33:38Z","timestamp":1326242018000},"page":"585-590","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Outcomes of Elective Total Laryngectomy for Laryngopharyngeal Dysfunction in Disease\u2010Free Head and Neck Cancer Survivors"],"prefix":"10.1002","volume":"146","author":[{"given":"Katherine A.","family":"Hutcheson","sequence":"first","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare P.","family":"Alvarez","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise A.","family":"Barringer","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael E.","family":"Kupferman","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter R.","family":"Lapine","sequence":"additional","affiliation":[{"name":"Michigan State University East Lansing Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan S.","family":"Lewin","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,10]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21022"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-009-9247-7"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.116.5.1251"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.1.54"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.3109\/17482960802578373"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1258\/002221504322731565"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-1609.2010.00177.x"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.129.1.44"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21399"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.126.11.1320"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.1059"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.9.1100"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.07.013"},{"key":"e_1_2_10_15_2","first-page":"103","article-title":"Hyperbaric oxygen therapy in the treatment of complications of irradiation in head and neck area","volume":"32","author":"Narozny W","year":"2005","journal-title":"Undersea Hyperb Med"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.06.1264"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2007.33"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(02)02712-8"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000297833.53794.27"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.10.050"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21807"},{"key":"e_1_2_10_22_2","first-page":"168","volume-title":"Head and Neck Cancer: A Multidisciplinary Approach","author":"Lewin JS"},{"key":"e_1_2_10_23_2","article-title":"Minimally\u2010invasive approach for the management of the leaking tracheoesophageal puncture","author":"Shuaib SW","journal-title":"Laryngoscope"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21399"},{"key":"e_1_2_10_25_2","doi-asserted-by":"publisher","DOI":"10.1044\/jshd.5203.212"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599811432264","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599811432264","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599811432264","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:48:20Z","timestamp":1760968100000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599811432264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1,10]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2012,4]]}},"alternative-id":["10.1177\/0194599811432264"],"URL":"https:\/\/doi.org\/10.1177\/0194599811432264","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,1,10]]},"assertion":[{"value":"2011-07-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-11-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-01-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}