Pitfalls after laryngectomy and neoglottis formation

Area of Science:

• Otorhinolaryngology
• Gastroenterology
• Surgical Oncology

Background:

• Laryngectomy, a surgical procedure to remove the larynx, can alter upper airway anatomy and function.
• The development of a hypopharyngeal-tracheal shunt is a common complication post-laryngectomy.
• Swallowing dysfunction and aspiration are significant concerns for patients following this surgery.

Purpose of the Study:

• To investigate the intraluminal pressure dynamics in the hypopharynx and sphincter area after laryngectomy.
• To correlate manometric findings with the incidence of aspiration in patients with hypopharyngeal-tracheal shunts.

Main Methods:

• Intraluminal manometry was performed in the hypopharynx and sphincter area of patients post-laryngectomy.
• Pressure recordings were analyzed during the act of swallowing.

Main Results:

• Manometric investigations revealed elevated pressure recordings of 54 mm Hg in the hypopharynx.
• Reduced pressure recordings of 33 mm Hg were noted in the sphincter area during swallowing.
• These pressure abnormalities provide a potential explanation for aspiration.

Conclusions:

• Abnormal pressure gradients in the hypopharynx and sphincter post-laryngectomy can lead to aspiration of saliva and food.
• Understanding these manometric findings is crucial for managing post-surgical complications.