Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction
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 o...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-10-01
|
| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.655 |
| _version_ | 1819179140283105280 |
|---|---|
| author | Joshua Stramiello Brian Nuyen Anirudh Saraswathula Liza Blumenfeld Vasu Divi Eben Rosenthal Ryan Orosco Heather M. Starmer |
| author_facet | Joshua Stramiello Brian Nuyen Anirudh Saraswathula Liza Blumenfeld Vasu Divi Eben Rosenthal Ryan Orosco Heather M. Starmer |
| author_sort | Joshua Stramiello |
| collection | DOAJ |
| description | 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 |
| first_indexed | 2024-12-22T21:53:43Z |
| format | Article |
| id | doaj.art-c81072fc160c4181995945d2a095b919 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-12-22T21:53:43Z |
| publishDate | 2021-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-c81072fc160c4181995945d2a095b9192022-12-21T18:11:17ZengWileyLaryngoscope Investigative Otolaryngology2378-80382021-10-01651031103610.1002/lio2.655Timing of postoperative oral feeding after head and neck mucosal free flap reconstructionJoshua Stramiello0Brian Nuyen1Anirudh Saraswathula2Liza Blumenfeld3Vasu Divi4Eben Rosenthal5Ryan Orosco6Heather M. Starmer7Division of Otolaryngology‐Head and Neck Surgery, Department of Surgery University of California San Diego School of Medicine San Diego California USADepartment of Otolaryngology‐Head and Neck Surgery Stanford University School of Medicine Stanford California USADepartment of Otolaryngology‐Head and Neck Surgery Stanford University School of Medicine Stanford California USADivision of Otolaryngology‐Head and Neck Surgery, Department of Surgery University of California San Diego School of Medicine San Diego California USADepartment of Otolaryngology‐Head and Neck Surgery Stanford University School of Medicine Stanford California USADepartment of Otolaryngology‐Head and Neck Surgery Stanford University School of Medicine Stanford California USADivision of Otolaryngology‐Head and Neck Surgery, Department of Surgery University of California San Diego School of Medicine San Diego California USADepartment of Otolaryngology‐Head and Neck Surgery Stanford University School of Medicine Stanford California USAAbstract 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: 3https://doi.org/10.1002/lio2.655early feedingfistulaFOISfree flap reconstructionswallow outcomes |
| spellingShingle | Joshua Stramiello Brian Nuyen Anirudh Saraswathula Liza Blumenfeld Vasu Divi Eben Rosenthal Ryan Orosco Heather M. Starmer Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction Laryngoscope Investigative Otolaryngology early feeding fistula FOIS free flap reconstruction swallow outcomes |
| title | Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction |
| title_full | Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction |
| title_fullStr | Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction |
| title_full_unstemmed | Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction |
| title_short | Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction |
| title_sort | timing of postoperative oral feeding after head and neck mucosal free flap reconstruction |
| topic | early feeding fistula FOIS free flap reconstruction swallow outcomes |
| url | https://doi.org/10.1002/lio2.655 |
| work_keys_str_mv | AT joshuastramiello timingofpostoperativeoralfeedingafterheadandneckmucosalfreeflapreconstruction AT briannuyen timingofpostoperativeoralfeedingafterheadandneckmucosalfreeflapreconstruction AT anirudhsaraswathula timingofpostoperativeoralfeedingafterheadandneckmucosalfreeflapreconstruction AT lizablumenfeld timingofpostoperativeoralfeedingafterheadandneckmucosalfreeflapreconstruction AT vasudivi timingofpostoperativeoralfeedingafterheadandneckmucosalfreeflapreconstruction AT ebenrosenthal timingofpostoperativeoralfeedingafterheadandneckmucosalfreeflapreconstruction AT ryanorosco timingofpostoperativeoralfeedingafterheadandneckmucosalfreeflapreconstruction AT heathermstarmer timingofpostoperativeoralfeedingafterheadandneckmucosalfreeflapreconstruction |