Primary soft tissue reconstruction after transoral laryngeal tumor resection.

OBJECTIVES/HYPOTHESIS Primary reconstruction by endoscopic buccal mucosal grafting can be considered in cancer patients with large defects and in patients with bilateral disease. We present our case series of primary endoscopic buccal grafting after cancer surgery. STUDY DESIGN Seventeen cases in 16 patients treated with buccal primary reconstruction (PR) are compared to 26 subjects without reconstruction (SO) and to 18 radiation patients (RO). The Voice Handicap Index, voice grade, and acoustic analysis were used to compare voice outcomes between groups. METHODS Case-control study. RESULTS There were more European Laryngological Association type II, III, and type Va resections in the PR group. Acoustic analysis, Voice Handicap Index short form, and perceptual ratings by three expert listeners showed no differences in voice outcomes between groups. There were voice-related differences between surgical patients, with the European Laryngological Association type I patients having better voices than European Laryngological Association type II, III, and Va groups combined. Voice outcomes showed mild to moderate dysphonia in all three groups. The presence of the buccal graft did not hinder tumor surveillance. CONCLUSIONS Primary reconstruction appears to be safe in patients with large soft tissue defects. There were no detectable functional differences between the PR, SO, and RO groups. LEVEL OF EVIDENCE 3b