title: Functional outcomes after different types of transoral supraglottic laryngectomy.
abstract: To seek a correlation between the four types of transoral supraglottic laryngectomies (TSLs) according to the European Laryngological Society (ELS) and postoperative morbidity.
  
  
  
  Retrospective case series at an academic institution.
  
  
  
  Chart review was done for 96 patients affected by T1-T3 supraglottic cancers (28 pT1, 46 pT2, 22 pT3) treated by TSL (29 type I, 14 type II, 35 type III, 18 type IV) with CO2 laser. Five-year overall survival (OS), disease-specific survival (DSS), local control with laser alone (LCL), and organ preservation (OP) were calculated by Kaplan-Meier curves. Thirty-six patients were submitted to swallowing evaluation by M. D. Anderson Dysphagia Inventory (MDADI), videoendoscopy of swallow (VEES), and videofluoroscopy (VFS). Hospitalization, tracheotomy, nasogastric feeding tube (NGFT), and complications were compared between type I-II versus III-IV TSLs for the entire series. MDADI and VEES/VFS scores were compared in the subgroup of 36 patients.
  
  
  
  Five-year OS, DSS, LCL, and OP rates were 69%, 85.9%, 89.2%, and 92.6%. Mean hospitalization was 9 days, tracheotomy was required in 7% of patients, an NGFT was required in 33%, and 11% experienced complications. Type III-IV TSLs were associated with increased hospitalization (P < .001), more NGFTs (P = .001), and 90% of complications (P = .021). Aspiration was seen in 0% and 9% of type I-II TSLs, and in 7% and 43% of type III-IV TSLs by VEES and VFS, respectively.
  
  
  
  Type III-IV TSLs present higher morbidity and complications, thus confirming the utility of the ELS classification in preoperative counseling and therapeutic planning.
  
  
  
  4 Laryngoscope, 126:1131-1135, 2016.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia.
authors.forename: Cesare
authors.initials: C
authors.lastname: Piazza
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia.
authors.forename: Diego
authors.initials: D
authors.lastname: Barbieri
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia.
authors.forename: Francesca
authors.initials: F
authors.lastname: Del Bon
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia.
authors.forename: Paola
authors.initials: P
authors.lastname: Grazioli
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia.
authors.forename: Pietro
authors.initials: P
authors.lastname: Perotti
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia.
authors.forename: Alberto
authors.initials: A
authors.lastname: Paderno
authors.affiliation: Department of Radiology, University of Brescia, Brescia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Frittoli
authors.affiliation: Department of Radiology, University of Brescia, Brescia.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Mazza
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, Genoa, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Penco
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, Genoa, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Gaggero
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia.
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, Genoa, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Peretti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Supraglottic cancer; functional outcomes; oncologic outcomes; swallowing; transoral laser surgery