A survey of feeding and swallowing function after free jejunal flap reconstruction in cases of head and neck cancer

Akioka,Hiroshi; Uemura,Hirokazu; Masui,Takashi; Ota,Ichiro; Kimura,Takahiro; Adachi,Shiori; Ueda,Keita; Shugyo,Masayuki; Tanaka,Akihisa; Kitahara,Tadashi

doi:10.3892/mco.2022.2549

A survey of feeding and swallowing function after free jejunal flap reconstruction in cases of head and neck cancer

Authors:
- Hiroshi Akioka
- Hirokazu Uemura
- Takashi Masui
- Ichiro Ota
- Takahiro Kimura
- Shiori Adachi
- Keita Ueda
- Masayuki Shugyo
- Akihisa Tanaka
- Tadashi Kitahara
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Affiliations: Department of Otolaryngology‑Head and Neck Surgery, Kindai University Nara Hospital, Ikoma, Nara 630‑0293, Japan, Department of Otolaryngology‑Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634‑8522, Japan
Published online on: May 25, 2022 https://doi.org/10.3892/mco.2022.2549
Article Number: 116

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Abstract

Reconstructive surgery using the free jejunum flap for locally advanced head and neck cancer is effective in preserving the swallowing function; however, it does not allow normal oral intake in all patients. A total of 47 patients underwent surgery at Nara Medical University between Jan 2010 and Dec 2019. The patients' ages ranged from 48 to 86 years. Sites were the hypopharynx (33 cases), larynx and cervical esophagus (5 cases each) and oropharynx (4 cases). Swallowing function was assessed using videofluorography, from the start of oral intake to discharge, as well as meal form at discharge. Lateral‑retropharyngeal‑lymph node dissection (LRPLND), preoperative radiation therapy, extended resection to the nasopharynx and incidence of stenosis in the jejuno‑esophageal anastomosis were examined. Significant differences were revealed in the scores of pharyngeal residues of contrast medium and pharyngeal contraction, with and without preoperative radiotherapy. LRPLND did not affect swallowing function; dissection group cases had lower scores for soft palate elevation. Overall, resection extended to the nasopharynx, and the anastomosis method did not affect scores of swallowing function.

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