[Diagnosis of postoperative dysphagia and aspiration. Fiberoptic-endoscopic controlled methylene blue drinking]

Postoperative swallowing disorders are common after such function-preserving surgery as conventional resections or endoscopic laser procedures for carcinomas of the larynx and hypopharynx. In most cases a reduction in motility of the pharyngeal muscles and sensory impairment of the pharyngeal and laryngeal regions can occur because of postoperative tissue abnormalities, including scarring due to the healing process. We have used fiberoptic endoscopic examinations with methylene blue to analyze postoperative swallowing and observe whether staining or aspiration occurs. By so doing, we have improved postoperative swallowing in 25 patients after extended surgery for cancer and were able to detect or exclude aspiration. The advantages of this minimally invasive, non-stressful diagnostic procedure are discussed and can be important for further successful care after surgery.