Glottic closure to prevent aspiration following supraglottic horizontal partial laryngectomy in elderly patients
10.3760/cma.j.cn115330-20250311-00138
- VernacularTitle:声门封闭术预防老年人喉声门上水平部分切除术后误吸的研究
- Author:
Jinrang LI
1
;
Jun JU
1
;
Jiasen WANG
1
;
Hongguang GUO
1
;
Jing ZHAO
1
Author Information
1. 中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科医学部咽喉嗓音外科 国家耳鼻咽喉疾病临床医学研究中心，北京 100048
- Publication Type:Journal Article
- Keywords:
Laryngeal neoplasms;
Supraglottic type;
Aspiration;
Glottis closure;
Partial laryngectomy
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(11):1352-1356
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of glottic closure in preventing postoperative aspiration in elderly patients undergoing supraglottic horizontal partial laryngectomy.Methods:A retrospective case series analysis was conducted on the clinical data of 12 elderly patients who underwent supraglottic horizontal partial laryngectomy with concurrent glottic closure at the Sixth Medical Center of Chinese PLA General Hospital from January 1, 2002, to December 31, 2024. Among them, there were 8 males and 4 females, aged from 68 to 80 years, with an average age of 74 years. There were 11 cases of supraglottic laryngeal cancer and 1 case of tongue base cancer. The TNM staging was T2N0M0 in 8 cases, T3N0M0 in 2 cases, T3N1M0 in 1 case, and T3N2M0 in 1 case. All patients existed comorbid cardiovascular dysfunction of varying severity. Pulmonary function tests were impaired in 8 cases. Comorbidities included hypertension ( n=5), prior coronary stent placement ( n=3), and thrombocytopenia ( n=1). Swallowing function was assessed using the EAT-10 (Eating Assessment Tool-10) one month postoperatively. All patients were followed up regularly. Results:The mean EAT-10 score at one month postoperatively was 2.42±1.71. Eleven patients successfully resumed oral feeding without obvious aspiration. Voice quality was intelligible when the tracheostomy tube was blocked. In the early stage, in 1 case, due to the suture technique problem of the glottis closure, the suture site of the glottis completely split open after the operation. The patient′s breathing was normal when the tube was blocked, and the tracheostomy tube was removed. As arytenoid edema resolved, the patient developed varying degrees of dysphagia with recurrent aspiration. This patient was hospitalized twice due to aspiration pneumonia, at 5 months and 19 months, postoperatively. The remaining 11 patients exhibited no signs of significant aspiration during follow-up. The 3-year and 5-year postoperative survival rates were 7/8 and 5/7, respectively.Conclusion:For elderly patients with supraglottic laryngeal cancer or tongue base cancer, and those who are at high risk for persistent postoperative aspiration after fully evaluated systematically, glottis closure during supraglottic horizontal partial laryngectomy is an effective strategy to prevent aspiration and to facilitate safe oral intake.
