National laryngopharyngectomy and reconstructive surgery survey

The surgical treatment of advanced carcinomas of the hypopharynx and larynx present many therapeutic challenges. Numerous reconstructive options have emerged but there has been little study why particular reconstructive options are selected. A nationwide survey was performed of otolaryngologists and plastic surgeons who perform head and neck reconstruction for laryngopharyngectomy defects. 200 surveys were mailed with a 36% response rate. Otolaryngologists were more likely to consider voice (p = 0.003) and swallowing (p = 0.02) outcomes compared to plastic surgeons. In contrast, plastic surgeons more often included cosmesis (p = 0.05) among those factors influencing their reconstructive choice. However, rank order analysis demonstrated no statistical difference between plastic surgeons and otolaryngologists with respect to each factor. Our study sought to: 1) understand which, and to what degree, various factors influence the surgeon in choosing a particular reconstructive method and, 2) study the various methods available to reconstruct total laryngopharyngectomy defects. Further research is necessary to provide an evidence base for which reconstructive method offers the optimal functional restoration.