Introduction: Free reconstructive surgery for oropharyngeal cancer or oral cancer often involves a tracheotomy to manage the airway. All cases undergo a tracheotomy in principle, and we have switched to Retina
Ⓡ (KOKEN) for when postoperative laryngeal edema has improved and there is reduced pulmonary aspiration of saliva. Previously, the switch to Retina was made on an empirical basis, but now we have switched to Retina by scoring and assessing laryngeal findings objectively. In this study, we investigated the usefulness of scoring by comparing the number of days after surgery when the switch to Retina was made, as well as the frequency of pneumonia.
Materials and methods: We scored the postoperative laryngeal findings of 51 patients who underwent free flap reconstruction for oropharyngeal cancer/oral cancer. Two doctors specializing in treating head and neck cancer gave one of three scores to three items: paralysis of the vocal cords, laryngeal edema, and retention of saliva, and calculated a total score. These were compared with 48 cases before the scoring was implemented.
Results: The scored patients were 36 men and 15 women, aged 22 to 86 (median: 65 years), with a median of 8 days after surgery when the switch to Retina was made, and three cases of pneumonia (6%). Cases from before scoring were 34 men and 14 women, with a median of 8.5 days after surgery when the switch to Retina was made, and two cases of pneumonia (4%).
Discussion: There was no apparent worsening between before and after the scoring was introduced. The switch to Retina, which was done on an empirical basis in the past, is made more objective by the scoring.
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