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Alongside a few classmates, I am working on expanding and improving the article on Laryngectomy. I think it could include a section on the impact of the surgery on oral feeding. Below are some articles of relevance to this issue.

Early oral feeding after total laryngectomy: A systematic review.

Efficacy of stapler pharyngeal closure after total laryngectomy: A systematic review.

Supracricoid laryngectomy and dysphagia: A systematic literature review.

Nutritional management in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.

Article Outline & Draft
The new section will cover post-laryngectomy oral feeding and dysphagia, and other related potential complications.

The laryngectomy surgery results in anatomical and physiological changes in the larynx and surrounding structures. Consequently, swallowing function can undergo changes as well, compromising the patient's oral feeding ability and nutrition. Patients may experience distress, frustration, and reluctance to eat out due to swallowing difficulties. Despite the high prevalence of post-operative swallowing difficulties in the first days following the laryngectomy, most patients recover swallowing function within 3 months.

Oral feeding after laryngectomy

Laryngectomy patients do not aspirate due to the structural changes in the larynx, but they may experience difficulty swallowing solid food. They may also experience changes in appetite due to a significant loss in their senses of taste and smell.

The most common complication to feeding resulting from total laryngectomy is the pharyngocutaneous fistula. This complication, which requires feeding to be completed via nasogastric tube, increases morbidity, length of hospitalization, and level of discomfort, and may delay rehabilitation. In order to prevent its development, it is common practice to reintroduce oral feeding as of the seventh to tenth day post-surgery, although the ideal timeline remains controversial. Pharyngocutaneous fistula typically develops before the reintroduction of oral feeding, as the pH level and presence of amylase in saliva is more harmful to tissues than other liquids or food. Whether the reintroduction of oral feeding at an earlier post-operative date decreases the risk of fistula remains unclear. However, early oral feeding (within 7 days of the operation) can be conducive to reduced length of hospital stay and earlier discharge from the hospital, entailing a decrease in costs and psychological distress.

Dysphagia and other complications

Questions & Concerns

 * I am wondering how to cite an article several times within a paragraph. Should it just be cited once at the end? Or several times, with the same number in brackets?
 * I am not sure whether I should focus only on oral feeding or include a sub-section on incidence of dysphagia as well. I will keep the focus on oral feeding in order not to extend to too many topics for one short section.