Early Oral Feeding After Total Laryngectomy

Abstract

The time to begin oral feeding after total laryngectomy remains a subject of debate among head and neck surgeons. The prevailing assumption is that early initiation of oral feeding may cause pharyngocutaneous fistula; thus, the common practice of initiating oral feeding after a period of 7 to 10 days. In most cases, the occurrence of a fistula results in prolongation of hospital stay with increased burden on the patient, surgeon, and health care system. These facts have an impact on patients’ return to work and social life as well as on the cost to the health system. The aim of this thesis, is to assess the value and effect of early oral feeding (2-5days), using a videofluoroscopic assessment as a test before starting early feeding. versus the effect of nasogastric tube feeding on the incidence of pharyngo-cutaneous fistula (PCF) and the duration of the hospital stay after total laryngectomy. This study consisted of two groups: one comprising 20 patients in whom oral feeds were initiated on the 5th postoperative dayin the period between december 2013 to May 2015,and a control group comprising 20 patients in whom oral feeds were initiated on the 10thpostoperative day at last three years ago. A total of 40 patients fulfilled the required criteria of