# Swallowing Function and Quality of Life in Patients Treated With Transoral Videolaryngoscopic Surgery for Pharyngolaryngeal Cancer

## TL;DR

This study examines how transoral surgery affects swallowing and quality of life in patients with throat cancer, finding that most maintain good function, though elderly patients are at higher risk for issues.

## Contribution

The study provides evidence that transoral videolaryngoscopic surgery preserves swallowing function in most patients, with age being a key risk factor for impairment.

## Key findings

- Most patients maintained good swallowing function after TOVS with favorable FOSS scores.
- Age ≥65 years was a significant predictor of impaired swallowing function post-surgery.
- Elderly patients with laryngeal hypoesthesia and poor clearance are at higher risk for swallowing dysfunction.

## Abstract

Background: It is controversial whether transoral resection for early pharyngolaryngeal cancer preserves swallowing function and quality of life. We investigated swallowing function and quality of life before and after transoral videolaryngoscopic surgery (TOVS).

Methods: Seventy-three patients with pharyngolaryngeal cancer who underwent TOVS between July 2012 and July 2022 were enrolled in this prospective analysis. The Hyodo score and European Organization for Research and Treatment of Cancer Quality of Life Questionnaires were recorded preoperatively and at three, six, and 12 months postoperatively, in addition to the postoperative functional outcome swallowing scale (FOSS) at six months postoperatively.

Results: Although most patients could consume food orally without restrictions with a preferable FOSS score, 23 patients showed impaired Hyodo scores. Age ≥65 years significantly predicted impaired swallowing. Sub-scores of the impaired patient group showed worsening for the glottal closure reflex when the endoscope touched the epiglottis or arytenoid, as well as a reduction in the extent of pharyngeal clearance following the ingestion of blue-dyed water.

Conclusion: After TOVS, swallowing function is generally well preserved. Elderly patients, especially those with laryngeal hypoesthesia and poor clearance, are at risk of swallowing dysfunction.