Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction

Laryngoscope Investigative Otolaryngology

Eben Rosenthal¹  Heather M. Starmer¹  Brian Nuyen¹  Anirudh Saraswathula¹  Vasu Divi¹  Liza Blumenfeld²  Joshua Stramiello²  Ryan Orosco² 

[1] Department of Otolaryngology‐Head and Neck Surgery Stanford University School of Medicine Stanford California USA;Division of Otolaryngology‐Head and Neck Surgery, Department of Surgery University of California San Diego School of Medicine San Diego California USA;

关键词: early feeding;    fistula;    FOIS;    free flap reconstruction;    swallow outcomes;   

DOI  :  10.1002/lio2.655

来源: DOAJ

【 摘 要 】

Abstract Objective Fistula remains a common complication of upper aerodigestive tract reconstruction. Optimal timing of oral feeding is unknown and the impact of early feeding on swallow function and fistula rates remains controversial. The purpose of this study is to better understand the effects of “early feeding” on fistula rate and swallow in patients with free flap reconstruction of upper aerodigestive tract defects. Methods Retrospective cohort study. One hundred and four patients undergoing free flap reconstruction of mucosalized head and neck defects. Two groups, early feeding (oral intake on or before postoperative day 5) and late‐feeding (oral intake after postoperative day 5). Primary outcome was incidence of salivary fistula. Secondary outcomes included Functional Oral Intake Scale scores. Results Fistula rate was 16.5% in late‐feeding group and 0% in early‐feeding group (P = .035). Patients who were fed early had an association with progression to a full oral diet by 30 days (P = .027). Discussion This cohort analysis suggests that in properly selected patients with free flap reconstruction for mucosal defects, early feeding may not increase risk of salivary fistula and may improve swallow functional outcomes earlier. Level of Evidence: 3

【 授权许可】

Unknown