Related Experiment Videos
Does laryngectomy improve swallowing after chemoradiotherapy? A case study
Cathy Lazarus1, Jeri A Logemann, Guoxiang Shi
1Voice, Speech and Language Service and Swallowing Center, Northwestern University Medical School, 201 E Huron St, Suite 10-205, Chicago, IL 60611, USA. claz@northwestern.edu
Archives of Otolaryngology--Head & Neck Surgery
|January 12, 2002
Summary
Total laryngectomy stops aspiration after head and neck cancer chemoradiotherapy. However, this surgery may not fully restore swallowing function, leaving patients with persistent oral and pharyngeal phase difficulties.
Area of Science:
- Otolaryngology
- Oncology
- Speech-Language Pathology
Background:
- High-dose chemoradiotherapy is common for head and neck cancers, often leading to significant swallowing dysfunction.
- Organ preservation strategies aim to treat cancer while minimizing long-term side effects like dysphagia.
Observation:
- A hypopharyngeal cancer patient underwent total laryngectomy post-chemoradiotherapy to address severe swallowing issues.
- Concurrent videofluorography and manometry assessed swallowing function, oral tongue pressures, and tongue base pressures.
- A healthy subject served as a control for comparative analysis.
Findings:
- The patient ceased aspiration post-laryngectomy but could only manage liquids and pureed foods.
- Impaired bolus clearance was observed in the oral cavity and pharyngoesophageal regions.
- Reduced pharyngeal pressures were noted compared to the healthy control.
Implications:
- Total laryngectomy effectively eliminates aspiration but may not resolve underlying swallowing impairments.
- Severe dysphagia following chemoradiation for hypopharyngeal tumors can persist despite laryngectomy.
- Further research is needed to optimize swallowing rehabilitation after laryngectomy in this patient population.