RESUMEN
BACKGROUND: To analyze worldwide practices regarding the initiation of oral feeding after total laryngectomy (TL). METHODS: Online survey. RESULTS: Among the 332 responses received, 278 from 59 countries were analyzed. Our results showed that 45.6% of respondents started water and 45.1% started liquid diet between postoperative days 7 and 10. Semi-solid feeds were initiated between days 10 and 14 for 44.9% of respondents and a free diet was allowed after day 15 for 60.8% of respondents. This timing was significantly delayed in cases of laryngo-pharyngectomy and after prior radiotherapy (p < 0.001). A greater proportion of respondents in Africa and Oceania allowed early oral feeding before day 6 as compared with the rest of the world (p < 0.001). CONCLUSION: Despite increasing number of publications, there is still a lack of evidence to support early oral feeding. The majority of respondents preferred to delay its initiation until at least 7 days after surgery.
Asunto(s)
Laringe , Enfermedades Faríngeas , Humanos , Laringectomía , Faringectomía , Complicaciones PosoperatoriasRESUMEN
Squamous cell carcinoma of the larynx is very rare in children and adolescents. It is usually diagnosed at late stages because early symptoms are often attributed to the maturation process or other common laryngeal pediatric diseases. Early visualization of vocal cords with fexible laryngoscopy is important in children presenting suggestive symptoms of laryngeal pathology. Defnitive diagnosis of carcinoma is made by biopsy, and juvenile laryngeal papillomatosis the most important differential diagnosis. Treatment constitutes a clinical challenge. There are no established protocols, and clinicians should make a special effort to preserve the functions of the larynx, and avoid long term complications. We present a 12-years-old child with invasive laryngeal carcinoma, without prior history of juvenile papillomatosis or radiotherapy, which responded favorably to chemotherapy and radiotherapy.
Asunto(s)
Carcinoma de Células Escamosas , Carcinoma de Células Escamosas/terapia , Niño , Humanos , Neoplasias Laríngeas/terapia , MasculinoRESUMEN
El carcinoma escamoso de laringe es muy raro en niños y adolescentes. Suele ser diagnosticado en estadios tardíos debido a los síntomas iniciales, atribuidos al proceso madurativo laríngeo o a otras enfermedades pediátricas más comunes. La visualización temprana de las cuerdas vocales con laringoscopia fexible es importante en niños que se presentan con síntomas sugestivos de patología laríngea. El diagnóstico de certeza de carcinoma lo proporciona la biopsia y el diagnóstico diferencial principal es la papilomatosis laríngea juvenil. El tratamiento constituye un desafío. No existen protocolos establecidos y se debe realizar un esfuerzo especial para preservar las funciones de la laringe y evitar complicaciones a largo plazo. Presentamos un niño de 12 años con carcinoma laríngeo invasor, sin historia previa de papilomatosis juvenil ni radioterapia, que respondió favorablemente al tratamiento con quimioterapia y radioterapia.
Squamous cell carcinoma of the larynx is very rare in children and adolescents. It is usually diagnosed at late stages because early symptoms are often attributed to the maturation process or other common laryngeal pediatric diseases. Early visualization of vocal cords with fexible laryngoscopy is important in children presenting suggestive symptoms of laryngeal pathology. Defnitive diagnosis of carcinoma is made by biopsy, and juvenile laryngeal papillomatosis the most important differential diagnosis. Treatment constitutes a clinical challenge. There are no established protocols, and clinicians should make a special effort to preserve the functions of the larynx, and avoid long term complications. We present a 12-years-old child with invasive laryngeal carcinoma, without prior history of juvenile papillomatosis or radiotherapy, which responded favorably to chemotherapy and radiotherapy.