Objective: To assess the long-term deglutition in patients undergone frontolateral laryngectomy (FL) by fiberoptic endoscopic evaluation of swallowing (FEES) and to identify factors that might influence the swallowing outcomes of these patients

Materials and Methods: A cross-sectional descriptive study in patients undergone FL between 2004 and 2014 with postoperative time of 6 months or more. Three parameters: premature spillage of material, retention/pooling of material, and the presence of penetration or aspiration were evaluated. All parameters were graded from one (severe) to five (normal).

Results: Total of 36 patients, 31 male and 5 female, with mean age of 58±12.9 years were included in the present study. Twenty-nine cases (80.6%) presented with stage I glottis cancers and 7 cases (19.4%) presented with stage II glottis-subglottic cancers. For their treatment by surgery, 30 cases (83.3%) underwent FL and 6 cases (16.7%) underwent extended FL. Swallowing function was determined to be normal in 27 cases (75%), however, 6 cases (16.7%) had mild residue accumulation after food swallowing, whereas 3 cases (8.3%) had moderate symptoms of either minimal pharyngeal stasis plus unsafe airway or moderate pharyngeal residue accumulation. When considering each factor that may worsen post-operative swallowing function, the results suggested that there were significant associations with age of ≥65 years old (p=0.036), tumor stage II (p=0.049), and the presence of postoperative wound infection (p=0.012).

Conclusion: In the present study, the authors confirmed that FL had minimal impacts on swallowing functions as the majority of patients who underwent FL recovered normal or near-normal swallowing function after 6 months as determined by FEES. However, long-term swallowing functions should be monitored especially in older patients (≥65 years of age), or patients with tumor stage II or postoperative wound infection.