National laryngopharyngectomy and reconstructive surgery survey.
OBJECTIVE
To understand the various methods available to reconstruct total laryngopharyngectomy defects and to understand which, and to what degree, various factors influence the surgeon in choosing a particular reconstructive method.


METHODS
Otolaryngologists and plastic surgeons who perform head and neck reconstruction were surveyed regarding preference of laryngopharyngectomy reconstruction. Numerical and rank-order data was analyzed using T statistics and Fisher exact test.


RESULTS
Two hundred surveys were mailed and 72 physicians (36% response rate) provided data, with otolaryngologists comprising 54% of the respondents. Otolaryngologists were more likely to consider voice (P = .003) and swallowing (P = .02) outcomes compared to plastic surgeons. In contrast, plastic surgeons more often included cosmesis (P = .05) among those factors influencing their reconstructive choice. However, rank-order analysis demonstrated no statistical difference between plastic surgeons and otolaryngologists with respect to each factor.


CONCLUSIONS
Our study sought to examine what motivates surgeons from several specialties to choose one reconstructive method over another for laryngopharyngeal defects. Otolaryngologists were more likely to consider voice and swallowing function in contrast to plastic surgeons, who more frequently included cosmesis as a factor. However, when physicians were asked to rank the importance of each of the eight factors from most to least important in influencing their reconstructive option, there was no statistical difference between plastic surgeons and otolaryngologists with respect to each factor. Further research is necessary to provide an evidence base for which reconstructive method offers the optimal functional restoration.
Richmon
Jeremy D
JD
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA.
Samji
Hussein A
HA
Deschler
Daniel G
DG
D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D002983:Clinical Competence; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007825:Laryngectomy / Q000379:methods* / Q000639:trends; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods* / Q000639:trends; D010611:Pharyngectomy / Q000379:methods* / Q000639:trends; D010818:Practice Patterns, Physicians'; D011336:Probability; D011787:Quality of Health Care; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000639:trends; D018570:Risk Assessment; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D014481:United States