Early Oral Feeding Following Primary Total Laryngectomy

  • Johannes J. FaganEmail author
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)


A systematic review is presented of the evidence relating to early vs. delayed oral feeding of patients who have undergone primary total laryngectomy and its relevance to clinical practice. Conclusions are that early oral feeding is not associated with an increased risk of pharyngocutaneous fistulae and can be recommended for patients undergoing primary total laryngectomy. Attention should be paid to nutritional requirements in patients on early oral feeding protocols who are not being supplemented via nasogastric or stomagastric feeds. However, there is insufficient evidence to make a recommendation about early feeding in the setting of pharyngeal reconstruction with free or pedicled flaps, or salvage total laryngectomy following (chemo)radiation.


Total laryngectomy Early oral feeding Pharyngocutaneous fistula rates Evidence-based 


  1. 1.
    Alonso JM. Cancer laringeo. Madrid, Spain: Editorial: Paz Montalvo; 1954.Google Scholar
  2. 2.
    Boyce SE, Meyers AD. Oral feeding after total laryngectomy. Head Neck. 1989;11(3):269–73.CrossRefGoogle Scholar
  3. 3.
    Martin S, Jordan Z, Carney SA. The effect of early oral feeding compared to standard oral feeding following total laryngectomy: a systematic review. JBI Libr Syst Rev. 2012;10(56 Suppl):1–13.PubMedGoogle Scholar
  4. 4.
    Aprigliano F. Use of the nasogastric tube after total laryngectomy: is it truly necessary? Ann Otol Rhinol Laryngol. 1990;99(7 Pt 1):513–4.CrossRefGoogle Scholar
  5. 5.
    Akyol MU, Ozdem C, Celikkanat S. Early oral feeding after total laryngectomy. Ear Nose Throat J. 1995;74:28–30.CrossRefGoogle Scholar
  6. 6.
    Saydam L, Kalcioglu T, Kizilay A. Early oral feeding following total laryngectomy. Am J Otolaryngol. 2002;23(5):277–81.CrossRefGoogle Scholar
  7. 7.
    Süslü N, Şefik Hoşal A. Early oral feeding after total laryngectomy: outcome of 602 patients in one cancer center. Auris Nasus Larynx. 2016;43(5):546–50.CrossRefGoogle Scholar
  8. 8.
    Soylu L, Kiroglu M, Aydogan B. Pharyngocutaneous fistula following laryngectomy. Head Neck. 1998;20:22–5.CrossRefGoogle Scholar
  9. 9.
    Medina JE, Khafif A. Early oral feeding following total laryngectomy. Laryngoscope. 2001;111(3):368–72.CrossRefGoogle Scholar
  10. 10.
    Prasad KC, Sreedharan S, Dannana NK, Prasad SC, Chandra S. Early oral feeds in laryngectomized patients. Ann Otol Rhinol Laryngol. 2006;115(6):433–8.CrossRefGoogle Scholar
  11. 11.
    Aswani J, Thandar M, Otiti J, Fagan J. Early oral feeding following total laryngectomy. J Laryngol Otol. 2009;123(3):333–8.CrossRefGoogle Scholar
  12. 12.
    Seven H, Calis AB, Turgut S. A randomized controlled trial of early oral feeding in laryngectomized patients. Laryngoscope. 2003;113(6):1076–9.CrossRefGoogle Scholar
  13. 13.
    Sharifian HA, Najafi M, Khajavi M. Early oral feeding following total laryngectomy. Tanaffos. 2008;7:64–70.Google Scholar
  14. 14.
    Sousa AA, Porcaro-Salles JM, Soares JM, de Moraes GM, Silva GS, Sepulcri RA, Savassi-Rocha PR. Does early oral feeding increase the likelihood of salivary fistula after total laryngectomy? J Laryngol Otol. 2014;15:1–7.Google Scholar
  15. 15.
    Stephenson K, Fagan JJ. The effect of perioperative proton pump inhibitors on the incidence of pharyngocutaneous fistula following total laryngectomy: a prospective randomized controlled trial. Head Neck. 2015;37(2):255–9.CrossRefGoogle Scholar
  16. 16.
    Sousa AA, Porcaro-Salles JM, Soares JM, Meyer de Moraes G, Souza Silva G, Abreu Sepulcri R, Rezende Carvalho J, Savassi-Rocha PR. Tolerance of early oral feeding in patients subjected to total laryngectomy. Head Neck. 2016;38(Suppl 1):E643–8.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Otorhinolaryngology, Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa

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