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Dysphagia after total laryngectomy.

F M McConnel1, D Cerenko, M S Mendelsohn

  • 1Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia.

Otolaryngologic Clinics of North America
|November 1, 1988
PubMed
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Swallowing difficulties after total laryngectomy stem from impaired negative pressure in the pharyngeal constrictor muscles, leading to delayed food transit. High oropharyngeal pressures may also cause fistulas post-surgery.

Area of Science:

  • Otolaryngology
  • Swallowing Disorders
  • Surgical Outcomes

Background:

  • Total laryngectomy significantly alters pharyngeal anatomy and function.
  • Swallowing impairments are a common complication following this procedure.

Purpose of the Study:

  • To quantitatively analyze swallowing function after total laryngectomy.
  • To compare post-laryngectomy swallowing with normal swallowing function.
  • To investigate the relationship between pharyngeal pressure dynamics and swallowing deficits.

Main Methods:

  • Quantitative analysis of swallowing function.
  • Comparison of swallowing data between total laryngectomy patients and healthy controls.

Main Results:

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  • Patients who underwent total laryngectomy exhibited a lack of negative pressure production in the pharyngoesophageal (PE) segment.
  • This impairment correlated with dysphagia (difficulty swallowing) and prolonged bolus transit times.
  • Elevated pressures in the oropharynx were observed, potentially contributing to fistula formation.

    • Conclusions:

    • Impaired negative pressure generation in the PE segment is a key factor in post-total laryngectomy dysphagia.
    • High oropharyngeal pressures represent a risk factor for complications such as fistulas after total laryngectomy.