TLM was associated with good early swallowing outcomes at 3 months and may offer a benefit over CRT. The results should be viewed as preliminary data, providing useful reference for any proposed controlled trial.

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There is no statistical difference for swallowing outcomes in either group. However, patients' in the rNGT group reported a clinically meaningful difference at 1 year, with a trend for them to do better across all measures. Neither group returned to their baseline swallowing function. Further research with a larger sample size is indicated.

Background Speech and language therapists (SLT) lack consensus with regard to assessing the swallow function of a patient with a cuff‐inflated tracheostomy. In the UK, one‐third would not accept such a referral due to perceived negative effects on swallow safety. Patients may be spending longer hospitalized and fed enterally as a result. Aims To establish the evidence base for aspiration risk in the adult population when eating/drinking with a cuff‐inflated tracheostomy. Methods & Procedures Systematic searches of seven key electronic databases, grey literature and reference lists of full‐text articles were conducted until January 2017. Two researchers independently identified eligible studies according to inclusion criteria (studies written in English, reporting aspiration rates in adult humans with inflated cuff tracheostomies). Methodological quality was assessed using the Downs and Black checklist. Owing to the heterogeneity of included studies in their design, population and measured outcomes, a narrative synthesis was employed. Outcomes & Results In total, 454 titles, 168 abstracts and 37 full papers were retrieved with 10 studies included in the final review. Methodological flaws and risk of bias were identified in all studies. Meta‐analysis was not feasible. Narrative synthesis found no study identified a statistically significantly higher incidence of aspiration in cuff‐inflated patients. Conclusions & Implications Evidence regarding aspiration risk is inconclusive. These results imply SLT services need to review policy to consider accepting referrals on a case‐by‐case basis, regardless of cuff status. Further research, though challenging to conduct, would inform best‐practice and policy/guideline development, allowing a consistent clinical approach.

This is the first study to report the results of a complimentary set of swallowing measures for patients treated with Transoral Laser Microsurgery, observed alongside a cohort of (chemo)radiotherapy patients. The preliminary results suggest a benefit in swallowing function for Transoral Laser Microsurgery over (chemo)radiotherapy during the year following treatment.