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Video

Head and Neck Surgery

(A539) Effects of Prophylactic Percutaneous Endoscopic Gastrostomy Placement on 12 month Swallow Function: A Retrospective Study

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Maya G. Hatley, BA

    Medical Student
    NYU Grossman School of Medicine
    New York, New York, United States

    • Co-Author(s)

  • KB

    Keisha Arielle Best, MD, MS

    Resident Physician
    NYU Langone - Department of Otolaryngology
    Sacramento, California, United States

    • Co-Author(s)

  • Elliot C. Morse, MD

    Otolaryngology Faculty
    NYU Grossman School of Medicine - Department of Otolaryngology
    NY, New York, United States

  • Gabriel D. Pujol, MD

    Head & Neck Oncologic and Microvascular Surgery; Facial Plastic & Reconstructive Surgery
    NYU Langone Health
    Guaynabo, Puerto Rico, United States

  • mA

    milan R. Amin, MD

    Professor of Otolaryngology
    NYU Grossman School of Medicine - Department of Otolaryngology
    NY, NY, United States

    • Senior Author(s)

  • aJ

    adam S. Jacobson, MD

    Director, Division of Head & Neck Surgery
    NYU Langone Health
    New York, New York, United States

Disclosure(s):
Keisha Arielle Best, MD, MS: No relevant relationships to disclose.
Elliot C. Morse, MD: No relevant relationships to disclose.
Maya G. Hatley, BA: No relevant relationships to disclose.
Gabriel D. Pujol, MD: No relevant relationships to disclose.


Introduction: This study aims to characterize the swallow outcomes of patients who undergo prophylactic percutaneous endoscopic gastrostomy (pPEG) tube placement following head and neck cancer (HNC) resection with reconstruction.

Methods: This is a single institution, retrospective cohort study of HNC patients undergoing resection and free flap reconstruction between January 2018 and December 2023. Eat Assessment Tool (EAT-10) and oral intake assessed by the Functional Oral Intake Scale (FOIS) immediately prior to surgery, PEG placement and removal dates, and 12-month post-op diet were collected. Data analysis was done via non-parametric t-test (Graphpad Prism).

Results: This retrospective study included 27 patients, 66.7% (n=18) of whom were male. The average PEG tube duration was 222.22 days. The majority of patients (81.5%) were functionally independent preoperatively, while 11.1% reported poor preoperative functional status.
Paired EAT-10 scores were available for 11.1% of patients with 8.33 total points improvement. Initial and 12-month postoperative EAT-10 scores ranged from 9-32 and 3-27, respectively. Non-parametric t-test analysis of FOIS score showed a significant difference between preoperative and postoperative scores (d= 2.053, p=0.0002***).
At 12-months post-operatively, 68.4% of patients (n=13/19) were consuming a full oral diet compared to 13% (n=3/23) at the initial post-op assessment. At the time of surgery, the median FOIS was 3. One year later, the median FOIS increased to 5, indicating most patients were consuming a total oral diet with multiple consistencies but continued to require special preparation or compensation strategies.

Conclusions: While pPEG is commonly done during HNC surgery, there are concerns that pPEG may impair long-term swallowing function. In this study, most patients returned to a full oral diet by 12 months postoperatively. This serves as evidence to guide future clinical protocols and enhance quality of life.