Pharyngeal Stenosis and Swallowing Dysfunction Following Laryngectomy: A Scoping Review
Background: Pharyngeal stenosis (PS) is a common sequela of a total laryngectomy (TL), and the most common cause of postoperative dysphagia. Its exact incidence is not known. A greater understanding of this clinical complication could serve to better inform patients considering a laryngectomy. Objec...
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MDPI AG
2025-05-01
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| Series: | Surgeries |
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| author | Akash Halagur Amar Sheth Shannon Wu Michael Belsky Edward J. Damrose |
| author_facet | Akash Halagur Amar Sheth Shannon Wu Michael Belsky Edward J. Damrose |
| author_sort | Akash Halagur |
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| description | Background: Pharyngeal stenosis (PS) is a common sequela of a total laryngectomy (TL), and the most common cause of postoperative dysphagia. Its exact incidence is not known. A greater understanding of this clinical complication could serve to better inform patients considering a laryngectomy. Objective: Pharyngeal stenosis (PS) is a common sequela of a total laryngectomy (TL) and causes dysphagia. This systematic review aims to characterize PS as a sequela of a TL, specifically the incidence of dysphagia requiring dilation, and the frequency/timing of dilation interventions. Data Sources: We used PubMed. Review Methods: A search of all studies from PubMed published from conception to January 2024 was conducted. Cohort studies reporting PS requiring dilation following a TL were included. Data were collected on the incidence, recurrence, median time from TL to dilation, TL indication, and reconstructive approach. Two evaluators independently performed the study screening and data collection; all the differences were resolved by a third evaluator. Results: Eleven studies met the inclusion criteria. A total of 1421 patients underwent a TL, of which 659 (46.4%) were salvage, 286 (20.1%) were the primary treatment, and 153 (10.8%) were the primary with an adjuvant treatment. A total of 255 patients underwent reconstruction, among whom 86 (33.7%) had regional and 169 (66.3%) had free flaps. The mean age at the time of the TL was 64.1 (range 20–87) years, with a male-to-female ratio of 3.4:1. The overall incidence of dysphagia after a TL requiring dilation was 26%. Of the 370 patients who required dilation, 69.4% required multiple procedures. The median time to the first dilation post-TL ranged from 9 to 24 months. The overall complication rate was 4.3%, including perforation, infection, and diminished tracheoesophageal voice quality. Conclusions: Approximately one in four patients developed stenosis requiring dilation after a TL, of which two out of three required repeat dilations. Major complications, though rare, were predominantly observed during the first few dilation procedures. |
| format | Article |
| id | doaj-art-c94b87b44afd454cbfa89a741859ae7e |
| institution | Kabale University |
| issn | 2673-4095 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgeries |
| spelling | doaj-art-c94b87b44afd454cbfa89a741859ae7e2025-08-20T03:29:38ZengMDPI AGSurgeries2673-40952025-05-01624110.3390/surgeries6020041Pharyngeal Stenosis and Swallowing Dysfunction Following Laryngectomy: A Scoping ReviewAkash Halagur0Amar Sheth1Shannon Wu2Michael Belsky3Edward J. Damrose4Geisel School of Medicine at Dartmouth, 1 Rope Ferry Rd, Hanover, NH 03755, USADepartment of Otolaryngology—Head and Neck Surgery, School of Medicine, Stanford University, 801 Welch Road, Stanford, CA 94305, USADepartment of Otolaryngology—Head and Neck Surgery, School of Medicine, Stanford University, 801 Welch Road, Stanford, CA 94305, USADepartment of Otolaryngology—Head and Neck Surgery, School of Medicine, Stanford University, 801 Welch Road, Stanford, CA 94305, USADepartment of Otolaryngology—Head and Neck Surgery, School of Medicine, Stanford University, 801 Welch Road, Stanford, CA 94305, USABackground: Pharyngeal stenosis (PS) is a common sequela of a total laryngectomy (TL), and the most common cause of postoperative dysphagia. Its exact incidence is not known. A greater understanding of this clinical complication could serve to better inform patients considering a laryngectomy. Objective: Pharyngeal stenosis (PS) is a common sequela of a total laryngectomy (TL) and causes dysphagia. This systematic review aims to characterize PS as a sequela of a TL, specifically the incidence of dysphagia requiring dilation, and the frequency/timing of dilation interventions. Data Sources: We used PubMed. Review Methods: A search of all studies from PubMed published from conception to January 2024 was conducted. Cohort studies reporting PS requiring dilation following a TL were included. Data were collected on the incidence, recurrence, median time from TL to dilation, TL indication, and reconstructive approach. Two evaluators independently performed the study screening and data collection; all the differences were resolved by a third evaluator. Results: Eleven studies met the inclusion criteria. A total of 1421 patients underwent a TL, of which 659 (46.4%) were salvage, 286 (20.1%) were the primary treatment, and 153 (10.8%) were the primary with an adjuvant treatment. A total of 255 patients underwent reconstruction, among whom 86 (33.7%) had regional and 169 (66.3%) had free flaps. The mean age at the time of the TL was 64.1 (range 20–87) years, with a male-to-female ratio of 3.4:1. The overall incidence of dysphagia after a TL requiring dilation was 26%. Of the 370 patients who required dilation, 69.4% required multiple procedures. The median time to the first dilation post-TL ranged from 9 to 24 months. The overall complication rate was 4.3%, including perforation, infection, and diminished tracheoesophageal voice quality. Conclusions: Approximately one in four patients developed stenosis requiring dilation after a TL, of which two out of three required repeat dilations. Major complications, though rare, were predominantly observed during the first few dilation procedures.https://www.mdpi.com/2673-4095/6/2/41laryngectomystenosisdysphagiadilationpharynx |
| spellingShingle | Akash Halagur Amar Sheth Shannon Wu Michael Belsky Edward J. Damrose Pharyngeal Stenosis and Swallowing Dysfunction Following Laryngectomy: A Scoping Review Surgeries laryngectomy stenosis dysphagia dilation pharynx |
| title | Pharyngeal Stenosis and Swallowing Dysfunction Following Laryngectomy: A Scoping Review |
| title_full | Pharyngeal Stenosis and Swallowing Dysfunction Following Laryngectomy: A Scoping Review |
| title_fullStr | Pharyngeal Stenosis and Swallowing Dysfunction Following Laryngectomy: A Scoping Review |
| title_full_unstemmed | Pharyngeal Stenosis and Swallowing Dysfunction Following Laryngectomy: A Scoping Review |
| title_short | Pharyngeal Stenosis and Swallowing Dysfunction Following Laryngectomy: A Scoping Review |
| title_sort | pharyngeal stenosis and swallowing dysfunction following laryngectomy a scoping review |
| topic | laryngectomy stenosis dysphagia dilation pharynx |
| url | https://www.mdpi.com/2673-4095/6/2/41 |
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