title: Is partial laryngectomy safe forever?
abstract: OBJECTIVE
  Over past decades, function-preserving surgery has been oncologically effective for specific types of laryngeal cancer. Although safe short-term swallow function has been reported, swallow safety during long-term survival has received less attention. The purpose of this report is to highlight potential consequences of late dysphagia and chronic aspiration after partial laryngectomy.
  
  
  METHODS
  A retrospective case series was performed. The head and neck cancer database from Yale-New Haven Hospital identified 3 patients requiring completion laryngectomy due to chronic aspiration 11-15 years after oncologically successful partial laryngectomy. Demographics, presentation, treatment, and course are included.
  
  
  RESULTS
  Primary treatment was open supraglottic laryngectomy with adjuvant radiation therapy (n=2) and vertical hemilaryngectomy (n=1). All patients demonstrated locoregional control and preservation of swallow function for >10 years postoperatively. Due to late dysphagia and chronic aspiration, two patients required completion laryngectomy 11 and 15 years postoperatively and the third patient will require this 14 years postoperatively.
  
  
  CONCLUSIONS
  Successful swallowing after function-preserving laryngeal surgery may not last forever despite adequate control of cancer. Three patients presented with aspiration 11-15 years after partial laryngectomy and required definitive completion laryngectomy. This observation may affect preoperative counseling and consideration for longer post-operative follow-up. The data encourage a larger sample size.
authors.affiliation: Yale School of Medicine, Department of Surgery, Section of Otolaryngology, New Haven, CT, United States. Electronic address: kenneth.bagwell@yale.edu.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Bagwell
authors.affiliation: Yale School of Medicine, Department of Surgery, Section of Otolaryngology, New Haven, CT, United States.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Leder
authors.affiliation: Yale School of Medicine, Department of Surgery, Section of Otolaryngology, New Haven, CT, United States.
authors.forename: Clarence T
authors.initials: CT
authors.lastname: Sasaki
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002908:Chronic Disease; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D053120:Respiratory Aspiration / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013997:Time Factors