Management of oral feeding following total laryngectomy around the world: YO‐IFOS international study

Abstract

Background: To analyze worldwide practices regarding the initiation of oral feeding after total laryngectomy (TL). Methods: Online survey.Results: Among the 332 responses received, 278 from 59 countries were analyzed. Our results showed that 45.6% of respondents started water and 45.1% started liquid diet between postoperative days 7 and 10. Semi-solid feeds were initiated between days 10 and 14 for 44.9% of respondents and a free diet was allowed after day 15 for 60.8% of respondents. This timing was significantly delayed in cases of laryngo-pharyngectomy and after prior radiotherapy (p < 0.001). A greater proportion of respondents in Africa and Oceania allowed early oral feeding before day 6 as compared with the rest of the world (p < 0.001). Conclusion: Despite increasing number of publications, there is still a lack of evidence to support early oral feeding. The majority of respondents preferred to delay its initiation until at least 7 days after surgery.

Early detection of pharyngocutaneous fistulae after total laryngectomy by cytokine in drainage: A pilot study (DEFILAC)

“…Of note, the patients in our study did not have an early oral intake of a clear fluid, despite it being shown to reduce the occurrence of PCF 20 . However, the refeeding method we used was similar to the refeeding practice of many teams 21 …”

“…20 However, the refeeding method we used was similar to the refeeding practice of many teams. 21 Our study population is representative of patients managed by TL, with a large number having received prior medical treatment, for example chemoradiotherapy (46%). The study also confirms the important consequences of PCF for the patients such as longer hospital stay and delayed return to oral intake.…”

Videofluoroscopic swallowing study to detect pharyngeal leak after total (pharyngo‐) laryngectomy: Retrospective assessment of a single‐institution protocol

“…The best timing for VFSS performance is a question that remains unanswered in the current literature. 19 Our study focused on a single post-operative protocol; therefore it could not compare various timings. While the time of salivary leak formation after TL is not accurately known, their occurrence before postoperative day 5 was exceptional in our study.…”

“…The best timing for VFSS performance is a question that remains unanswered in the current literature 19 . Our study focused on a single post‐operative protocol; therefore it could not compare various timings.…”