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

Abstract

BackgroundWe aimed to assess the effectiveness of a single‐institution protocol of videofluoroscopic swallowing study (VFSS) for the detection of pharyngeal leak (PL) and its usefulness to mitigate evolution into subsequent pharyngocutaneous fistula (PCF) after total (pharyngo‐) laryngectomy (TL).MethodsThis retrospective single‐center study was conducted between February 2014 and December 2022. We included all patients who underwent TL and performed a VFSS between Day 7 and Day 14 postoperatively to detect a subclinical PL.ResultsTwo‐hundred and forty‐eight patients met the inclusion criteria. Among the 186 patients (75%) with a negative VFSS, 11 patients (5.9%) developed a secondary PCF after oral intake resumption (false negative of VFSS). Among the 62 patients (25%) with a positive VFSS, the occurrence of a PCF was avoided in 59.7% of cases.ConclusionThis study showed a good effectiveness of VFSS in the detection of PL after TL, alongside a usefulness to mitigate evolution into subsequent PCF.