Evidence map›Paper›PMID 41389118›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025

Enhanced recovery after surgery: a prospective cohort study on ibSLN preservation in transoral laser surgery for pyriform sinus carcinoma.

Peiying Huang, Shisheng Li, Qinglai Tang, Xinming Yang, Shiying Zeng, Qian Yang, Bin Wang

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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7 authors.

Peiying HuangDepartment of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Shisheng LiDepartment of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Qinglai TangDepartment of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Xinming YangDepartment of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Shiying ZengDepartment of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Qian YangDepartment of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Bin WangDepartment of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China. 228202151@csu.edu.cn.

Funding

National Natural Science Foundation of China No. 81870711Natural Science Foundation of Hunan Province No.2021JJ40845
6 · The paper itself

Abstract

backgroundTransoral endoscopic head and neck surgery is an important modality in hypopharyngeal carcinoma therapy. Minimally invasive techniques and nerve protection are important components of Enhanced Recovery After Surgery principles. However, the limited surgical space and the challenges in identifying the internal branch of the superior laryngeal nerve (ibSLN) pose difficulties during this procedure. This study investigated the effects of preserving the ibSLN during transoral laser surgery on the postoperative swallowing rehabilitation of patients diagnosed with pyriform sinus carcinoma.

methodsA prospective cohort study with a retrospective control group was performed, including 42 patients with pyriform sinus carcinoma who had previously undergone transoral laser surgery. The participants were categorized into the ibSLN dissection and control groups. In the ibSLN dissection group, the ibSLN was exposed and dissected without nerve lesions. Traditional transoral surgery without proactive ibSLN dissection was performed in the control group. Demographics, operative data, postoperative swallowing function, tube removal time, and postoperative hospitalization time were evaluated and compared between both groups.

resultsAlthough the surgery time was longer in the ibSLN dissection group, the normal food intake, tube removal time, and postoperative hospitalization times were significantly shorter than those in the control group (P < 0.05). The MD Anderson Dysphagia Inventory (MDADI) scores after surgery significantly improved in the ibSLN dissection group. At 14 days post-surgery, significant improvements were observed in the four MDADI subset scores: global (P < 0.001), emotional (P < 0.05), functional (P < 0.05), and physical (P < 0.05). The postoperative water swallowing test showed a significantly faster swallowing speed in the ibSLN dissection group compared to the control group (P < 0.001). Fiberoptic endoscopic evaluation of swallowing showed a reduction in the epiglottic mobility impairment, aspiration, and residue in the pyriform fossa in the ibSLN dissection group, although the difference was not statistically significant.

conclusionsIdentification and dissection of the ibSLN can be successfully performed during transoral laser surgery in patients with pyriform sinus carcinoma. ibSLN dissection during transoral laser surgery has the potential to mitigate the risk of ibSLN damage, thereby facilitating enhanced recovery after surgery.

Indexed as

Enhanced Recovery After SurgeryHypopharyngeal NeoplasmsLaser TherapyPyriform SinusAdultAgedCase-Control StudiesCohort StudiesDeglutitionFemaleHumansMaleMiddle AgedProspective StudiesRetrospective StudiesEnhanced Recovery after SurgeryHypopharyngeal squamous cell carcinomaInternal branch of the superior laryngeal nerveSwallowing functionTransoral laser surgery

Identifiers

PMID41389118

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