# The practice of oral feeding after total laryngectomy by Brazilian head and neck surgeons

## TL;DR

Brazilian surgeons typically start oral feeding 7 days after uncomplicated laryngectomy, with delays for complex cases.

## Contribution

This study provides insights into current Brazilian surgical practices regarding post-laryngectomy oral feeding timelines.

## Key findings

- 40.5% of surgeons introduced water between days 7 and 9 after uncomplicated total laryngectomy.
- Liquid diets began between days 7-9 in 41.9% of uncomplicated cases.
- Significant differences in feeding timelines were observed based on prior therapy and surgical complexity.

## Abstract

•Oral feeding is usually offered after 7 days of surgery for uncomplicated cases without previous radiation therapy or extension of surgery to the hypopharynx.•The enteral feeding is kept up to 15 days for complicated cases, salvage surgery of pharyngolaryngectomy cases.•Patients offered oral feeding before the 10th day of surgery are discharged from the hospital within 14 days of surgery.

Oral feeding is usually offered after 7 days of surgery for uncomplicated cases without previous radiation therapy or extension of surgery to the hypopharynx.

The enteral feeding is kept up to 15 days for complicated cases, salvage surgery of pharyngolaryngectomy cases.

Patients offered oral feeding before the 10th day of surgery are discharged from the hospital within 14 days of surgery.

To evaluate the initiation of oral feeding in patients following TL by a group of Brazilian head and neck surgeons.

Online survey – 75 responders from Brazil.

40.5% of the respondents introduced water and 41.9% of them introduced liquid diets between days 7 and 9 after TL without surgical complications or previous radiotherapy. Semi-solid feeds were started between days 10 and 14 in 47.3% of the patients and a free diet was begun after day 15 in 79.7% of them. There was statistically significant difference in the initiation of liquid feeds between different groups of TL patients, with earlier initiation in TL patients who had not undergone prior radio(chemo)therapy (p = 0.01419), with even greater differences when complex closure of the pharynx was needed (p = 0.00001), but not regarding the moment of a free diet introduction.

Most respondents in this Brazilian cohort prefer to wait at least 7-days before beginning oral feeding after TL without previous radiotherapy or surgical complications, with a significant number of respondents postponing feeds in patients who had undergone salvage TL and pharyngolaryngectomy.

Level IV.