Our Summary

This research paper is a review of existing studies about the factors that can cause difficulty swallowing, or dysphagia, after a specific type of throat surgery known as supracricoid laryngectomy. This surgery is often used to treat laryngeal cancer. The paper looked at 31 different studies on the subject and found that dysphagia is a common problem after this surgery. However, it also found that patients generally recover well and severe complications are rare. The studies discussed a variety of factors that may influence swallowing ability, such as the type of reconstruction used, whether the patient had swallowing training or radiation therapy, the removal of a specific type of cartilage, whether additional procedures were performed, and the patient’s age. The paper suggests that future research could be improved by using a more consistent group of patients and standardized guidelines for the surgery and measuring swallowing function.

FAQs

  1. What is supracricoid laryngectomy and why is it performed?
  2. What factors can influence a patient’s ability to swallow after a supracricoid laryngectomy?
  3. What improvements does the research paper suggest for future studies on dysphagia after supracricoid laryngectomy?

Doctor’s Tip

A helpful tip a doctor might give a patient after a laryngectomy is to practice swallowing exercises regularly to improve swallowing function and prevent complications. It is important to follow the recommendations of a speech therapist or swallowing specialist to ensure proper technique and progress. Additionally, staying well-hydrated and eating a balanced diet can also help with swallowing difficulties. Regular follow-up appointments with your healthcare team are essential to monitor your progress and address any concerns.

Suitable For

Patients who are typically recommended for laryngectomy include those with advanced laryngeal cancer that cannot be treated by other methods such as radiation therapy or chemotherapy. Other factors that may lead to a recommendation for laryngectomy include recurrent or persistent laryngeal cancer, a history of failed previous treatments, or a tumor that is invading nearby structures. Additionally, patients who have severe dysphagia, aspiration pneumonia, or airway obstruction may also be recommended for laryngectomy. It is important for patients to discuss the risks and benefits of laryngectomy with their healthcare provider to determine if it is the best treatment option for their specific situation.

Timeline

Before laryngectomy:

  1. Patient undergoes diagnostic tests to confirm laryngeal cancer diagnosis.
  2. Patient may receive chemotherapy and/or radiation therapy to shrink the tumor.
  3. Patient undergoes pre-operative counseling and education about the surgery and potential changes to speech and swallowing.

After laryngectomy:

  1. Patient undergoes surgery to remove the larynx and possibly surrounding tissue.
  2. Patient may have a temporary or permanent tracheostomy tube placed to help with breathing.
  3. Patient begins rehabilitation to learn new ways of speaking and swallowing.
  4. Patient may experience difficulty swallowing, known as dysphagia, which can be managed through therapy and dietary modifications.
  5. Patient may experience changes in taste, smell, and saliva production.
  6. Patient may experience emotional and psychological challenges related to the changes in communication and appearance.
  7. Over time, patients typically adapt to the changes and improve their swallowing function with continued therapy and support.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laryngectomy include:

  1. What are the potential complications and side effects of laryngectomy surgery?
  2. How long is the recovery process after laryngectomy surgery?
  3. Will I need speech therapy or swallowing therapy after the surgery?
  4. How will my ability to swallow be affected after laryngectomy surgery?
  5. Are there any dietary restrictions I should follow after laryngectomy surgery?
  6. Will I need any additional procedures or treatments after laryngectomy surgery?
  7. How often should I follow up with my doctor after laryngectomy surgery?
  8. What can I do to help improve my swallowing function after laryngectomy surgery?
  9. Are there any support groups or resources available for patients who have undergone laryngectomy surgery?
  10. What are the long-term effects of laryngectomy surgery on swallowing function and overall quality of life?

Reference

Authors: Lips M, Speyer R, Zumach A, Kross KW, Kremer B. Journal: Laryngoscope. 2015 Sep;125(9):2143-56. doi: 10.1002/lary.25341. Epub 2015 May 25. PMID: 26013745