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Respiratory-Swallow Pattern Following Total Laryngectomy.

Amy Fullerton1, Yuhan Mou2, Natalie Silver3

  • 1Department of Speech, Language and Hearing Sciences, University of Florida, 1600 Archer Road, P.O. Box 100174, Gainesville, FL, 32610, USA. afullert@phhp.ufl.edu.

Dysphagia
|July 7, 2019
PubMed
Summary

Total laryngectomy patients often swallow during inspiration, unlike healthy adults. This study found no significant differences in respiratory-swallowing patterns based on tracheoesophageal puncture or food type.

Keywords:
DeglutitionDeglutition disordersLaryngectomyRespiratory-swallow patternSwallow-breathing coordination

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Area of Science:

  • * Respiratory physiology
  • * Swallowing disorders
  • * Head and neck oncology

Background:

  • * Altered respiratory-swallow patterns are common in head and neck cancer (HNC) patients.
  • * Total laryngectomy significantly impacts airway and swallowing functions.
  • * Tracheoesophageal puncture (TEP) is a common rehabilitation method post-laryngectomy.

Purpose of the Study:

  • * To characterize respiratory patterns during swallowing in total laryngectomees.
  • * To investigate the influence of tracheoesophageal puncture (TEP) on respiratory-swallow patterns.
  • * To determine if bolus consistency (thin liquid vs. solid) affects respiratory-swallow patterns.

Main Methods:

  • * 12 adult total laryngectomy patients (excluding those with active chemoradiation, esophageal cancer, neurologic disease, lung cancer, recurrence, or cognitive deficits) participated.
  • * Participants swallowed thin liquid (water) and solid (graham cracker) boluses.
  • * Submental surface electromyography (EMG) detected swallows, and airflow was measured via a custom stoma mask and pneumotachograph.

Main Results:

  • * Total laryngectomees demonstrated a preference for swallowing during inspiration.
  • * This inspiratory swallow pattern is consistent with findings in the broader HNC population but differs from healthy adults who prefer expiration.
  • * No significant differences in respiratory-swallow patterns were observed based on the presence or absence of TEP or bolus consistency.

Conclusions:

  • * Total laryngectomy patients exhibit an inspiratory-dominant respiratory-swallow pattern.
  • * The presence of TEP and bolus consistency did not significantly alter this observed pattern.
  • * Findings contribute to understanding the complex interplay of respiration and swallowing post-laryngectomy.