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Title: Laryngeal Suspension in Major Glossectomy: Impact on Functional Outcomes


Authors: Anuja Deshmukh 2, Anup Srinivas 1, Arun Balaji 6, Kirti Khandelwal 3, Richa Vaish 4, Suman Kumar 5
Publication: Journal of The Irish Head and Neck Society - 2025
Issue: 3 Volume: 3
Published: December, 2024 View PDF

Background:
Major glossectomy impacts speech and swallowing. Laryngeal suspension (LS) using a hyomandibular stitch facilitates laryngeal elevation and hyoid advancement. This study evaluates the functional outcomes of LS in patients undergoing major glossectomy.

Materials & Methods:
A retrospective analysis of 55 patients who underwent major glossectomy via the pull-through approach (January 2022–January 2024) was conducted.

Results:
Patient Distribution:
• Total/Near-Total Glossectomy (TG): 34 patients.
• Hemi/Extended Hemiglossectomy (HG): 21 patients.
• LS performed on 40 patients (TG: 27, HG: 13).

Aspiration Rates:
• TG: 44% (LS) vs. 75% (no LS).
• HG: 23% (LS) vs. 38% (no LS).
Oral Feeding Initiation (<4 months):
• TG: 67% (LS) vs. 13% (no LS, p=0.007).
• HG: 85% (LS) vs. 75% (no LS).

Laryngeal Elevation (Modified Water Swallow Test):
• TG: 52% (LS) vs. 25% (no LS).
• HG: 92% (LS) vs. 63% (no LS, p=0.011).

Videofluoroscopy Study (VFSS):
Laryngeal elevation was measured as the distance between the lower border of C2 and the anterior cornu of the air column. Two-thirds of patients with LS achieved favorable scores, compared to one-third without LS.

Conclusion:
Laryngeal suspension via a hyomandibular stitch significantly improves swallowing function and laryngeal elevation in major glossectomy patients. The technique demonstrates superior functional outcomes, including reduced aspiration rates and expedited initiation of oral feeding.

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