Vol.:(0123456789) 1 3 European Archives of Oto-Rhino-Laryngology https://doi.org/10.1007/s00405-020-06105-5 HEAD AND NECK The results of sequential swallowing assessments after total laryngectomy for laryngeal and hypopharyngeal malignancies Arun Balaji 1  · Shivakumar Thiagarajan 2,7  · Harsh Dhar 3  · Akshat Malik 4  · Atanu Bhattacharjee 5  · Adhara Chakraborthy 2  · Snehal Shah 2  · Supreet Nayyar 6  · Devendra Chaukar 2 Received: 17 March 2020 / Accepted: 3 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020 Abstract Background Swallowing after total laryngectomy (TL) is altered and the swallowing related issues are largely underreported. It is important to identify factors that may negatively infuence swallowing after TL in order to rehabilitate these patients appropriately. Methods The study included patients who underwent TL from June 2015 to November 2017 for laryngeal and hypopharyn- geal malignancy. Sequential swallowing assessment was done in these patients over time. The assessments were done using the FOIS scale and the PSS-HN normalcy of diet scores and analysed to assess the presence of swallowing related issues, factors infuencing swallowing and its recovery over time. Results Sixty-seven who underwent total laryngectomy (TL) were included in the study. Swallowing assessments were done once in 3 months. Overall there was an improvement in swallowing over time. Both the FOIS (Median score of 3.82 in frst to 5.77 in the ffth visit) and the PSS-HN scores (median score of 33.63 at frst visit to 63.66 at ffth visit) improved over time. Patients undergoing TL after treatment failure with chemoradiotherapy (p value < 0.001) and those with advanced stage disease (p-value < 0.001) did poorly in terms of swallowing. At the last follow up only 8 patients were dependent on feeding tube; the rest of the patients were able to take food orally. Conclusion Following total laryngectomy swallowing gradually improves in the frst 18 months after surgery. It is essential to identify factors infuencing swallowing negatively so that these patients can get appropriate attention to improve swallowing. Keywords Laryngectomy · Rehabilitation · Swallowing · Deglutition · Deglutition disorders Introduction Swallowing is a well-coordinated action involving the safe passage of food bolus through the aerodigestive tract, avoiding penetration into the airway. [1] This process may be afected by the disease, as in advanced laryngeal and hypopharyngeal cancers, and/or subsequent to the treatment for the same [2, 3]. The incidence of swallowing related problems following total laryngectomy (TL) has not been consistently reported in the literature (17–72%) [4–7]. Patients with advanced Presentation: Poster Presentation at FHNO, 2018, India. * Shivakumar Thiagarajan drshiva78in@gmail.com 1 Division of Speech and Swallowing, Department of Head & Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India 2 Department of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India 3 Narayana Superspeciaility Hospital, Howrah, Kolkata, West Bengal, India 4 Crossing Chair Hospital, London, UK 5 Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhaba National Institute (HBNI), Navi Mumbai, India 6 Department of ENT, Base Hospital, New Delhi, India 7 Department of Head & Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai 400012, India