Swallowing ability and chronic aspiration after supracricoid partial laryngectomy

Otolaryngol Head Neck Surg. 2010 Jun;142(6):873-8. doi: 10.1016/j.otohns.2010.01.035.

Abstract

Objective: Sporadic episodes of aspiration may occur after supracricoid partial laryngectomy. To prevent risks of pulmonary consequences, a limitation of oral intake of food or a "nothing by mouth" regimen has been suggested. The objective of this study was to evaluate the long-term swallowing and pulmonary status of patients after supracricoid partial laryngectomy.

Study design: Case series with chart review.

Setting: Tertiary University Hospital Policlinico "Umberto I" and Santa Lucia Foundation, Rome, Italy.

Subjects and methods: The swallowing status of a selected group of 116 patients who recovered functional deglutition after supracricoid partial laryngectomy was analyzed during follow-up consultation. Swallowing evaluation included clinical observation, fiberoptic endoscopic evaluation of swallowing, and a videofluoroscopy. When aspiration was confirmed by videofluoroscopy, a high-resolution computed tomography (CT) of the chest was performed in order to assess the radiological manifestations of aspiration. A group of 45 patients with chronic obstructive pulmonary disease and normal deglutition was used as a control.

Results: Seventy-nine patients out of 116 showed a fiberoptic endoscopic evaluation of swallowing suggestive for aspiration; only 45 patients had aspiration confirmed by videofluoroscopy. No significant differences in radiological findings were noted in the patients affected by postoperative chronic aspiration compared to the control group.

Conclusion: Patients with functional deglutition after supracricoid partial laryngectomy show a mild and well-tolerated degree of chronic aspiration and do not require a limitation of oral intake of food.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / surgery
  • Deglutition Disorders / epidemiology
  • Deglutition*
  • Diet
  • Female
  • Humans
  • Inhalation
  • Laryngeal Neoplasms / epidemiology
  • Laryngeal Neoplasms / surgery
  • Laryngectomy* / adverse effects
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Period
  • Pulmonary Disease, Chronic Obstructive / epidemiology