Short-term and long-term follow-up of pulmonary function in patients with COPD after total laryngectomy: A prospective study

Abstract

Objective: There exists no standardized method for examining lung function in laryngectomized patients.

Study design and methods: We established a base plate adapter (BPA) system for patients after laryngectomy. In 10 patients with chronic obstructive pulmonary disease (COPD), we evaluated pulmonary function before laryngectomy, as well as 2 weeks and 3 months after laryngectomy.

Results: The BPA system was well tolerated and delivered reliable results comparable to measurements with a mouthpiece. The parameters forced expiratory volume in one second (FEV₁ ), forced vital capacity (FVC), and mean forced expiratory flow between 25% and 75% of forced vital capacity (MFEF_25-75 ) changed in the early postoperative examinations (2 weeks postoperative), whereas MFEF_25-75 , FEF₇₅ , peak expiratory flow (PEF), and peak inspiratory flow (PIF)) showed differences from baseline in long-term follow-up (3 months postoperative).

Conclusion: We provide a practicable method of lung function testing in laryngectomized patients with COPD that is essential to tailor inhalation therapy despite tracheotomy. Lung function measurements of laryngectomized patients with COPD should be performed under stable clinical conditions a few weeks after surgery. Guidelines of COPD might be complemented considering the subgroup of laryngectomized patients.

Level of evidence: 4. Laryngoscope, 127:2045-2049, 2017.

Keywords: COPD; Spirometry; lung function; total laryngectomy.