Abstract：
OBJECTIVE: Cervical chordoma is a rare, low-grade primary bone tumor occurring in the axial skeleton. Due to challenges in surgical exposure caused by anatomic location, patients may experience dysfunction in speech and swallowing. The objective of this study was to characterize speech and swallowing outcomes for patients undergoing surgical resection of cervical chordoma. Moreover, we detail in-depth two cases with similar initial presentations to compare prognostic factors and management strategies.
METHODS: Eleven patients with histologically confirmed cervical chordoma treated between 1993 and 2020 were included in this retrospective case series. Outcomes measured included overall survival, disease-free survival, need for enteral feeds, as well as results of modified barium swallow study (MBSS) and fiberoptic laryngoscopy.
RESULTS: The mean age at diagnosis was 55.9 years. The patient population was 81.8% male. Mean survival after diagnosis was 96 months. Four (36.4%) patients required post-operative MBSS and demonstrated aspiration. All four of these patients presented with tumors in the superior cervical spine and received surgeries utilizing anterior approaches. Of the four, 2 required enteral feeds long-term. Four (36.4%) patients endorsed dysphonia. One patient developed post-operative right vocal fold paresis. The remaining three patients experienced stable dysphonia pre- and post-operatively. Additionally, three (27%) patients required tracheostomy placement, two of which remained in place long-term.
CONCLUSIONS: Dysphagia is a common side effect of cervical chordoma resection. It is associated with the use of an anterior approach during resection and with tumors located in the superior cervical spine. Patients with postoperative dysphagia should receive early multidisciplinary swallow rehabilitation.
METHODS: 4 Laryngoscope, 134:3706-3712, 2024.
METHODS: Eleven patients with histologically confirmed cervical chordoma treated between 1993 and 2020 were included in this retrospective case series. Outcomes measured included overall survival, disease-free survival, need for enteral feeds, as well as results of modified barium swallow study (MBSS) and fiberoptic laryngoscopy.
RESULTS: The mean age at diagnosis was 55.9 years. The patient population was 81.8% male. Mean survival after diagnosis was 96 months. Four (36.4%) patients required post-operative MBSS and demonstrated aspiration. All four of these patients presented with tumors in the superior cervical spine and received surgeries utilizing anterior approaches. Of the four, 2 required enteral feeds long-term. Four (36.4%) patients endorsed dysphonia. One patient developed post-operative right vocal fold paresis. The remaining three patients experienced stable dysphonia pre- and post-operatively. Additionally, three (27%) patients required tracheostomy placement, two of which remained in place long-term.
CONCLUSIONS: Dysphagia is a common side effect of cervical chordoma resection. It is associated with the use of an anterior approach during resection and with tumors located in the superior cervical spine. Patients with postoperative dysphagia should receive early multidisciplinary swallow rehabilitation.
METHODS: 4 Laryngoscope, 134:3706-3712, 2024.
摘要：
目的：颈部脊索瘤是一种罕见的，低级别原发性骨肿瘤发生在中轴骨骼。由于解剖位置引起的手术暴露的挑战，患者可能会出现言语和吞咽功能障碍。这项研究的目的是描述接受宫颈脊索瘤手术切除的患者的言语和吞咽结果。此外，我们详细介绍了两个初始表现相似的病例,以比较预后因素和治疗策略.
方法：本回顾性病例系列包括1993年至2020年间治疗的11例经组织学证实的宫颈脊索瘤患者。测量的结果包括总生存率，无病生存,需要肠内喂养，以及改良钡吞咽研究（MBSS）和纤维喉镜检查的结果。
结果：诊断时的平均年龄为55.9岁。患者群体为81.8%男性。诊断后的平均生存期为96个月。四名（36.4％）患者需要术后MBSS并表现出误吸。所有四名患者均表现为上颈椎肿瘤，并接受了前路手术。四个人中,2长期需要肠内喂养。四名（36.4％）患者认可发声障碍。一名患者术后出现右声带麻痹。其余三名患者在术前和术后均出现稳定的发声障碍。此外,三名(27%)患者需要气管造口术，其中两个仍然是长期的。
结论：吞咽困难是宫颈脊索瘤切除术的常见副作用。它与切除期间前路的使用以及位于上颈椎的肿瘤有关。术后吞咽困难患者应接受早期多学科吞咽康复。
方法：4喉镜，134:3706-3712,2024.
方法：本回顾性病例系列包括1993年至2020年间治疗的11例经组织学证实的宫颈脊索瘤患者。测量的结果包括总生存率，无病生存,需要肠内喂养，以及改良钡吞咽研究（MBSS）和纤维喉镜检查的结果。
结果：诊断时的平均年龄为55.9岁。患者群体为81.8%男性。诊断后的平均生存期为96个月。四名（36.4％）患者需要术后MBSS并表现出误吸。所有四名患者均表现为上颈椎肿瘤，并接受了前路手术。四个人中,2长期需要肠内喂养。四名（36.4％）患者认可发声障碍。一名患者术后出现右声带麻痹。其余三名患者在术前和术后均出现稳定的发声障碍。此外,三名(27%)患者需要气管造口术，其中两个仍然是长期的。
结论：吞咽困难是宫颈脊索瘤切除术的常见副作用。它与切除期间前路的使用以及位于上颈椎的肿瘤有关。术后吞咽困难患者应接受早期多学科吞咽康复。
方法：4喉镜，134:3706-3712,2024.
