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

Laryngoscope Investigative Otolaryngology

article

Joshua Stramiello¹  Brian Nuyen²  Anirudh Saraswathula²  Liza Blumenfeld¹  Vasu Divi²  Eben Rosenthal²  Ryan Orosco¹  Heather M. Starmer² 

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

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

DOI  :  10.1002/lio2.655

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

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.

【 授权许可】

CC BY|CC BY-NC-ND