Dilation after laryngectomy : Incidence, risk factors and complications
| Autor: | Luuk M. Janssen, Thomas F. Pezier, Jolanda M. van Dieren, Michiel W. M. van den Brekel, Richard Dirven, Tom van Putten, Remco de Bree, Japke F. Petersen, Vincent van der Noort, Sandra I. Bril |
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| Přispěvatelé: | Graduate School, Maxillofacial Surgery (AMC) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Larynx medicine.medical_specialty Cancer Research Pharyngeal stenosis medicine.medical_treatment Total laryngectomy Laryngectomy Young Adult 03 medical and health sciences 0302 clinical medicine SDG 3 - Good Health and Well-being Risk Factors medicine Journal Article Humans Cumulative incidence 030223 otorhinolaryngology Aged Retrospective Studies Aged 80 and over Radiotherapy business.industry Incidence Retrospective cohort study Sequela Larynx cancer Middle Aged medicine.disease Dilatation Primary tumor Surgery Radiation therapy Dilation Stenosis medicine.anatomical_structure Chemoradiation Oncology 030220 oncology & carcinogenesis Female Oral Surgery business |
| Zdroj: | Oral oncology, 91, 107-112. Elsevier Limited Oral Oncology, 91, 107. Elsevier Limited Oral Oncology, 91, 107-112. Elsevier Limited Petersen, J F, Pézier, T F, van Dieren, J M, van der Noort, V, van Putten, T, Bril, S I, Janssen, L, Dirven, R, van den Brekel, M W M & de Bree, R 2019, ' Dilation after laryngectomy : Incidence, risk factors and complications ', Oral Oncology, vol. 91, pp. 107-112 . https://doi.org/10.1016/j.oraloncology.2019.02.025 |
| ISSN: | 1368-8375 |
| Popis: | Background Neopharyngeal stenosis is a recognized sequela of total laryngectomy (TL). We aim to investigate the incidence of stenosis requiring dilation, risk factors for stenosis and complications of dilation. Methods Retrospective cohort study of patients undergoing TL in two dedicated head and neck centers in the Netherlands. Results A total of 477 patients, (81% men, median age of 64 at TL) were included. Indication for TL was previously untreated primary tumor in 41%, salvage following (chemo)radiotherapy (CRT) in 44%, dysfunctional larynx in 9% and a second primary tumor in 6%. The cumulative incidence of dilatation at 5 years was 22.8%, and in total 968 dilatations were performed. Median number of dilations per patient was 3 (range 1–113). Female gender, a hypopharynx tumor, and (C)RT before or after the TL were significantly associated with stenosis requiring dilation. We observed 8 major complications (0.8%) predominantly during the first dilation procedures. Use of general anesthesia is a risk factor for complications. The most frequent major complication was severe esophageal perforation (n = 6 in 5 patients). Conclusion The cumulative incidence of pharyngeal stenosis needing dilation was 22.8% at 5 years. Roughly half of these patients could be treated with a limited number of dilations, the rest however needed ongoing dilations. Major complications are rare (0.8%) but can be life threatening. General anesthetics is a risk factor for complications, and complications occurred predominantly during the first few dilations procedures. This should alert the physician to be extra careful in new patients. |
| Databáze: | OpenAIRE |
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