title: Variation in surgical methods used for total laryngectomy in Australia.
abstract: Deglutition disorders (dysphagia) are common following total laryngectomy. As the aetiology of the disorder is poorly understood, its incidence is probably under-estimated. Dysphagia may result from many factors, including the type of laryngectomy surgery employed and the use of adjuvant treatments (e.g. radiotherapy and chemotherapy). Dysphagia may also be compounded by other co-morbid factors, such as ageing and depression.
  
  
  OBJECTIVE
  To investigate the methods of surgical closure used by Australian ENT and head and neck surgeons after undertaking total laryngectomy surgery.
  
  
  METHODS
  In order to audit surgical variation, 56 short questionnaires were sent to all Australian ENT and head and neck surgeons who were registered members of the Australia and New Zealand Head and Neck Society. Twenty-eight questionnaires (50 per cent) were completed and returned.
  
  
  RESULTS
  Respondents reported using a variety of different reconstructive methods after total laryngectomy surgery. Specifically, there were differences in the type and levels of pharyngeal closure employed and the suturing techniques used.
  
  
  CONCLUSIONS
  Currently, there is no scientific evidence to direct surgeons to the optimal pharyngeal reconstruction technique(s) ensuring for good swallowing results post-laryngectomy. An analysis of the effect of surgical reconstruction technique on laryngectomees' post-operative swallowing ability is needed, in order to provide evidence to determine optimal surgical techniques.
authors.affiliation: Cancer Care Centre, St George Hospital, Sydney, New South Wales, Australia. Julia.Maclean@sesiahs.health.nsw.gov.au
authors.forename: J
authors.initials: J
authors.lastname: Maclean
authors.forename: S
authors.initials: S
authors.lastname: Cotton
authors.forename: A
authors.initials: A
authors.lastname: Perry
mesh_terms: D001315:Australia; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods* / Q000534:rehabilitation; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000592:standards*; D011184:Postoperative Period; D010818:Practice Patterns, Physicians'; D011788:Quality of Life; D011795:Surveys and Questionnaires