The practice of oral feeding after total laryngectomy by Brazilian head and neck surgeons

Introduction: This is an international survey on the timing of oral feeding after total laryngectomy (TL). Among the 332 responses received, 75 were from Brazilian head and neck surgeons. This subgroup of respondents was analyzed because of its proportionally large contribution. Objective: To evaluate the initiation of oral feeding in patients following TL by a group of Brazilian head and neck surgeons. Methods: Online survey – 75 responders from Brazil. Results: 40.5% of the respondents introduced water and 41.9% of them introduced liquid diets between days 7 and 9 after TL without surgical complications or previous radiotherapy. Semi-solid feeds were started between days 10 and 14 in 47.3% of the patients and a free diet was begun after day 15 in 79.7% of them. There was statistically significant difference in the initiation of liquid feeds between different groups of TL patients, with earlier initiation in TL patients who had not undergone prior radio(chemo)therapy (p=0.01419), with even greater differences when complex closure of the pharynx was needed (p=0.00001), but not regarding the moment of a free diet introduction. Conclusion: Most respondents in this Brazilian cohort prefer to wait at least 7 days before beginning oral feeding after TL without previous radiotherapy or surgical complications, with a significant number of respondents postponing feeds in patients who had undergone salvage TL and pharyngolaryngectomy.